Filing · f0042

Blue Medicare Advantage (PPO)

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

This plan reported a 3.0% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Medicare Advantage plans of comparable size is 10.9%. 2 checks flagged this filing.

Standard denial rate
3.0%
This filing published percentages without counts. 74.2% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 3.0%
Expedited 2.8%

This payer also printed its own standard denial rate: 3.0%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate74.2%

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

Turnaround
MeanMedian
Standard4.0 d2.0 d
Expedited16.1 h8.6 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