Filing · f0248

myBlue (HMO) / BlueCare (HMO-POS)

GuideWell / Florida Blue · Marketplace QHP · FL · 30252 · CY2025

This plan reported a 1.0% 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
1.0%
This filing published percentages without counts. 30.0% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 1.0%
Expedited 2.0%
Extended review, approved 0

This payer also printed its own standard denial rate: 1.0%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate30.0%

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

Turnaround
MeanMedian
Standard0.2 d
Expedited0.2 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