Filing · f0204
Community Health Choice CHIP & CHIP Perinatal (combined)
Community Health Choice · CHIP Managed Care · TX ·
In 2025 this plan received 2,858 standard prior authorization requests and denied 16.6% of them. The median for CHIP Managed Care plans of comparable size is 15.6%. One check flagged this filing.
Standard denial rate
16.6%
2,858 standard requests, 475 denied.
56.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 2,858 | 2,383 | 475 | 16.6% |
| Expedited | 232 | 193 | 39 | 16.8% |
| Extended review, approved | 10 | |||
This payer also printed its own standard denial rate: 17.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 41 |
| Denials overturned | 23 |
| Overturn rate | 56.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 9.0 d | 3.0 d |
| Expedited | 288.0 h | 72.0 h |
What the checks found
warnexpedited_slower_than_standard
expedited mean 288.0h exceeds standard mean 9.00d (216h)