Healthy Blue + Medicare (HMO-POS D-SNP)
Blue Cross and Blue Shield of North Carolina · Medicare Advantage · NC · Jan 1, 2025 - Dec 31, 2025
This plan reported a 2.7% 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 | — | — | — | 2.7% |
| Expedited | — | — | — | 1.5% |
This payer also printed its own standard denial rate: 2.7%. The rate above is computed from the published counts, so the two can be compared.
| Appeals filed | — |
| Denials overturned | — |
| Overturn rate | 86.1% |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |
no appeal outcome data published
filing publishes percentages without underlying counts; arithmetic cannot be verified