Filing · cfhp-starplus
Community First Texas Medicaid STAR+PLUS
Community First Health Plans · Medicaid Managed Care · TX · CY2025
In 2025 this plan received 8,980 standard prior authorization requests and denied 7.2% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. 2 checks flagged this filing.
Standard denial rate
7.2%
8,980 standard requests, 646 denied.
35.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 8,980 | 7,715 | 646 | 7.2% |
| Expedited | 5,421 | 4,242 | 233 | 4.3% |
Appeals of standard denials
| Appeals filed | 88 |
| Denials overturned | 31 |
| Overturn rate | 35.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 4.0 d |
| Expedited | 36.0 h | 24.0 h |
What the checks found
errorexp_counts_reconcile
4,242 approved + 233 denied = 4,475, but total is 5,421 (946 unaccounted, 17.5%)
errorstd_counts_reconcile
7,715 approved + 646 denied = 8,361, but total is 8,980 (619 unaccounted, 6.9%)