Filing · f0394
Texas Children's Health Plan (STAR/CHIP/STAR Kids combined)
Texas Children's Health Plan · Multiple (combined) · TX · 2025
In 2025 this plan received 128,038 standard prior authorization requests and denied 9.9% of them. The median for Multiple (combined) plans of comparable size is 6.3%.
Standard denial rate
9.9%
128,038 standard requests, 12,698 denied.
38.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 128,038 | 115,340 | 12,698 | 9.9% |
| Expedited | 4,867 | 4,601 | 266 | 5.5% |
| Extended review, approved | 7,574 | |||
This payer also printed its own standard denial rate: 9.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 2,740 |
| Denials overturned | 1,042 |
| Overturn rate | 38.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | — | — |
| Expedited | — | — |