Filing · f0359

Oscar Health - North Carolina

Oscar Health · Marketplace QHP · NC · 69803 · CY2025

This plan reported a 17.1% 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
17.1%
This filing published percentages without counts. 43.8% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 17.1%
Expedited 34.7%

This payer also printed its own standard denial rate: 17.1%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate43.8%

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

Turnaround
MeanMedian
Standard2.1 d0.8 d
Expedited45.6 h45.6 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