Filing · f0247

BlueOptions (PPO) / BlueSelect (EPO)

GuideWell / Florida Blue · Marketplace QHP · FL · 16842 · CY2025

This plan reported a 5.0% 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
5.0%
This filing published percentages without counts. 28.0% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 5.0%
Expedited 4.0%
Extended review, approved 0

This payer also printed its own standard denial rate: 5.0%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate28.0%

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

Turnaround
MeanMedian
Standard1.0 d
Expedited0.3 h0.0 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