Horizon NJ FamilyCare (Medicaid)
Horizon Blue Cross Blue Shield of New Jersey · Medicaid Managed Care · NJ · CY2025
This plan reported a 17.7% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Medicaid Managed Care plans of comparable size is 12.3%. 2 checks flagged this filing.
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | — | — | — | 17.7% |
| Expedited | — | — | — | 9.3% |
This payer also printed its own standard denial rate: 17.7%. The rate above is computed from the published counts, so the two can be compared.
| Appeals filed | — |
| Denials overturned | — |
| Overturn rate | 25.3% |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
| Mean | Median | |
|---|---|---|
| Standard | 7.0 d | 4.0 d |
| Expedited | 48.0 h | 24.0 h |
no appeal outcome data published
filing publishes percentages without underlying counts; arithmetic cannot be verified