Experience Health Medicare Advantage (HMO)
Blue Cross and Blue Shield of North Carolina · Medicare Advantage · NC · Jan 1, 2025 - Dec 31, 2025
This plan reported a 3.9% 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.
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | — | — | — | 3.9% |
| Expedited | — | — | — | 9.8% |
This payer also printed its own standard denial rate: 3.9%. The rate above is computed from the published counts, so the two can be compared.
| Appeals filed | — |
| Denials overturned | — |
| Overturn rate | 66.7% |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 3.0 d |
| Expedited | 16.1 h | 8.3 h |
no appeal outcome data published
filing publishes percentages without underlying counts; arithmetic cannot be verified