Filing · f0041

Blue Cross NC ACA (Marketplace) plans

Blue Cross and Blue Shield of North Carolina · Marketplace QHP · NC · Jan 1, 2025 - Dec 31, 2025

This plan reported a 17.5% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Marketplace QHP plans of comparable size is 18.3%. 2 checks flagged this filing.

Standard denial rate
17.5%
This filing published percentages without counts. 47.3% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 17.5%
Expedited 11.8%

This payer also printed its own standard denial rate: 17.5%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate47.3%

This filing publishes no appeal outcome. CMS-0057-F does not require one.

Turnaround
MeanMedian
Standard2.2 d1.0 d
Expedited34.5 h20.5 h
What the checks found
infoappeals_not_reported

no appeal outcome data published

infopercentages_only

filing publishes percentages without underlying counts; arithmetic cannot be verified