Every filing checked against itself

std_counts_reconcile error 19 approved + denied ≠ stated total see 19 → exp_counts_reconcile error 13 same, expedited see 13 → appeals_exceed_total error 1 more overturns than appeals filed see 1 → expedited_slower_than_standard warn 20 expedited turnaround exceeding standard see 20 → high_denial_rate warn 11 rates far outside the peer range see 11 → expedited_exceeds_standard_volume warn 10 transposed standard/expedited columns see 10 → zero_denial_rate warn 7 0% denial reported see 7 → std_headline_excludes_extended warn 1 extended-review cases outside the headline see 1 → appeals_not_reported info 139 no appeal outcome published see 139 → percentages_only info 119 no counts, so arithmetic cannot be checked see 119 →

Sentara Health Plans - Medicare
Sentara Health · VA error appeals_exceed_total 134 overturned exceeds 127 appeals filed Geisinger Health Plan (all lines of business, aggregated)
Geisinger Health · PA error exp_counts_reconcile 2,830 approved + 168 denied = 2,998, but total is 3,039 (41 unaccounted, 1.3%) AmeriHealth Caritas Louisiana
AmeriHealth Caritas · LA error exp_counts_reconcile 1,697 approved + 114 denied = 1,811, but total is 1,821 (10 unaccounted, 0.5%) AmeriHealth Caritas North Carolina
AmeriHealth Caritas · NC error exp_counts_reconcile 1,192 approved + 174 denied = 1,366, but total is 1,410 (44 unaccounted, 3.1%) Contra Costa Health Plan (Medi-Cal)
Contra Costa Health · CA error exp_counts_reconcile 6,167 approved + 885 denied = 7,052, but total is 7,676 (624 unaccounted, 8.1%) Jackson Care Connect
CareOregon · OR error exp_counts_reconcile 3,623 approved + 157 denied = 3,780, but total is 3,749 (-31 unaccounted, 0.8%) Community First Texas Medicaid STAR
Community First Health Plans · TX error exp_counts_reconcile 7,178 approved + 276 denied = 7,454, but total is 8,994 (1,540 unaccounted, 17.1%) AmeriHealth Caritas New Hampshire
AmeriHealth Caritas Family of Companies · NH error exp_counts_reconcile 778 approved + 129 denied = 907, but total is 934 (27 unaccounted, 2.9%) Columbia Pacific CCO
CareOregon · OR error exp_counts_reconcile 2,582 approved + 148 denied = 2,730, but total is 2,712 (-18 unaccounted, 0.7%) Community First Texas Medicaid STAR+PLUS
Community First Health Plans · TX error exp_counts_reconcile 4,242 approved + 233 denied = 4,475, but total is 5,421 (946 unaccounted, 17.5%) AmeriHealth Caritas VIP Care (Michigan)
AmeriHealth Caritas Family of Companies · MI error exp_counts_reconcile 452 approved + 64 denied = 516, but total is 521 (5 unaccounted, 1.0%) University Community Care Plan (Marketplace)
Community First Health Plans · TX error exp_counts_reconcile 358 approved + 28 denied = 386, but total is 499 (113 unaccounted, 22.6%) Community First CHIP
Community First Health Plans · TX error exp_counts_reconcile 174 approved + 24 denied = 198, but total is 242 (44 unaccounted, 18.2%) Community First Medicare Advantage (Alamo & D-SNP)
Community First Health Plans · TX error exp_counts_reconcile 110 approved + 7 denied = 117, but total is 142 (25 unaccounted, 17.6%) Keystone First
AmeriHealth Caritas · PA error std_counts_reconcile 234,056 approved + 89,408 denied = 323,464, but total is 314,611 (-8,853 unaccounted, 2.8%) Wisconsin Medicaid (ForwardHealth) -- specific program/agency not named in document
Wisconsin Department of Health Services · WI error std_counts_reconcile 148,796 approved + 6,556 denied = 155,352, but total is 165,012 (9,660 unaccounted, 5.9%) AmeriHealth Caritas Louisiana
AmeriHealth Caritas · LA error std_counts_reconcile 76,939 approved + 9,398 denied = 86,337, but total is 87,451 (1,114 unaccounted, 1.3%) AmeriHealth Caritas North Carolina
AmeriHealth Caritas · NC error std_counts_reconcile 65,448 approved + 11,698 denied = 77,146, but total is 77,905 (759 unaccounted, 1.0%) First Choice by Select Health of South Carolina
AmeriHealth Caritas Family of Companies · SC error std_counts_reconcile 57,563 approved + 13,195 denied = 70,758, but total is 72,229 (1,471 unaccounted, 2.0%) Contra Costa Health Plan (Medi-Cal)
Contra Costa Health · CA error std_counts_reconcile 51,203 approved + 6,741 denied = 57,944, but total is 61,899 (3,955 unaccounted, 6.4%) Mississippi Medicaid Fee-for-Service
Mississippi Division of Medicaid · MS error std_counts_reconcile 52,480 approved + 6,119 denied = 58,599, but total is 60,252 (1,653 unaccounted, 2.7%) NH Healthy Families
Centene · NH error std_counts_reconcile 33,320 approved + 5,310 denied = 38,630, but total is 39,685 (1,055 unaccounted, 2.7%) Jackson Care Connect
CareOregon · OR error std_counts_reconcile 32,263 approved + 2,631 denied = 34,894, but total is 34,544 (-350 unaccounted, 1.0%) Community First Texas Medicaid STAR
Community First Health Plans · TX error std_counts_reconcile 18,828 approved + 955 denied = 19,783, but total is 20,481 (698 unaccounted, 3.4%) AmeriHealth Caritas New Hampshire
AmeriHealth Caritas Family of Companies · NH error std_counts_reconcile 13,815 approved + 3,265 denied = 17,080, but total is 17,385 (305 unaccounted, 1.8%) Columbia Pacific CCO
CareOregon · OR error std_counts_reconcile 14,569 approved + 1,230 denied = 15,799, but total is 15,531 (-268 unaccounted, 1.7%) Community First Texas Medicaid STAR Kids
Community First Health Plans · TX error std_counts_reconcile 10,773 approved + 638 denied = 11,411, but total is 12,378 (967 unaccounted, 7.8%) Wyoming Medicaid Utilization Management (FFS)
Wyoming Department of Health · WY error std_counts_reconcile 9,294 approved + 1,106 denied = 10,400, but total is 10,708 (308 unaccounted, 2.9%) Community First Texas Medicaid STAR+PLUS
Community First Health Plans · TX error std_counts_reconcile 7,715 approved + 646 denied = 8,361, but total is 8,980 (619 unaccounted, 6.9%) Michigan Medicaid Home and Community Based Services (Aging and Community Services Division, incl. Brain Injury Services and Community Transition Services) - Fee-for-Service
Michigan Department of Health and Human Services · MI error std_counts_reconcile 3,165 approved + 175 denied = 3,340, but total is 3,371 (31 unaccounted, 0.9%) University Community Care Plan (Marketplace)
Community First Health Plans · TX error std_counts_reconcile 2,631 approved + 76 denied = 2,707, but total is 2,726 (19 unaccounted, 0.7%) Community First Medicare Advantage (Alamo & D-SNP)
Community First Health Plans · TX error std_counts_reconcile 482 approved + 13 denied = 495, but total is 508 (13 unaccounted, 2.6%) Harvard Pilgrim Health Care – New Hampshire Exchange Local Choice
Point32Health · NH error std_counts_reconcile 150 approved + 29 denied = 179, but total is 182 (3 unaccounted, 1.6%) Colorado Access
Colorado Access · CO warn expedited_exceeds_standard_volume expedited volume 17,006 exceeds standard 16,654 (1.0x) - columns may be transposed Rocky Mountain Health Plans RAE (Medicaid Regional Accountable Entity)
Rocky Mountain Health Plans · CO warn expedited_exceeds_standard_volume expedited volume 8,660 exceeds standard 8,244 (1.1x) - columns may be transposed Highmark Medicare Advantage contract H5932
Highmark · PA warn expedited_exceeds_standard_volume expedited volume 11,889 exceeds standard 7,010 (1.7x) - columns may be transposed Northeast Health Partners (Regional Accountable Entity)
Northeast Health Partners · CO warn expedited_exceeds_standard_volume expedited volume 6,572 exceeds standard 4,203 (1.6x) - columns may be transposed Aetna Better Health Kids (Pennsylvania CHIP)
CVS Health / Aetna · PA warn expedited_exceeds_standard_volume expedited volume 2,990 exceeds standard 2,066 (1.4x) - columns may be transposed Rocky Mountain Health Plans - QHP On-Exchange
Rocky Mountain Health Plans · CO warn expedited_exceeds_standard_volume expedited volume 4,534 exceeds standard 1,418 (3.2x) - columns may be transposed Rocky Mountain Health Plans PRIME (Medicaid)
Rocky Mountain Health Plans · CO warn expedited_exceeds_standard_volume expedited volume 8,068 exceeds standard 1,336 (6.0x) - columns may be transposed Peak Health
Peak Health · WV warn expedited_exceeds_standard_volume expedited volume 4,664 exceeds standard 937 (5.0x) - columns may be transposed Rocky Mountain Health Plans Medicare Advantage
Rocky Mountain Health Plans · CO warn expedited_exceeds_standard_volume expedited volume 465 exceeds standard 294 (1.6x) - columns may be transposed Generations Advantage HMO - Behavioral Health
Martin's Point Health Care · ME warn expedited_exceeds_standard_volume expedited volume 166 exceeds standard 131 (1.3x) - columns may be transposed CountyCare Health Plan (HealthChoice Illinois Medicaid)
CountyCare Health Plan (Cook County Health) · IL warn expedited_slower_than_standard expedited mean 21.1h exceeds standard mean 0.87d (21h) Ambetter from Superior HealthPlan (29418)
Centene · TX warn expedited_slower_than_standard expedited mean 72.0h exceeds standard mean 2.00d (48h) Wisconsin Medicaid (ForwardHealth) -- specific program/agency not named in document
Wisconsin Department of Health Services · WI warn expedited_slower_than_standard expedited mean 151.2h exceeds standard mean 3.10d (74h) Kaiser Foundation Health Plan of the Mid-Atlantic States
Kaiser Permanente · MD warn expedited_slower_than_standard expedited mean 4.0h exceeds standard mean 0.13d (3h) Ambetter from Superior HealthPlan (87226)
Centene · TX warn expedited_slower_than_standard expedited mean 72.0h exceeds standard mean 2.00d (48h) Highmark QHP (federal Marketplace) - Pennsylvania
Highmark · PA warn expedited_slower_than_standard expedited mean 11.8h exceeds standard mean 0.43d (10h) Mississippi Medicaid Fee-for-Service
Mississippi Division of Medicaid · MS warn expedited_slower_than_standard expedited mean 110.3h exceeds standard mean 3.13d (75h) Community Health Choice STAR & STAR+PLUS (combined)
Community Health Choice · TX warn expedited_slower_than_standard expedited mean 192.0h exceeds standard mean 7.00d (168h) Maryland HealthChoice
UnitedHealth Group · MD warn expedited_slower_than_standard expedited mean 24.0h exceeds standard mean 0.00d (0h) Highmark QHP (federal Marketplace) - West Virginia
Highmark · WV warn expedited_slower_than_standard expedited mean 13.4h exceeds standard mean 0.41d (10h) New York Wellness 4Me (HARP)
UnitedHealth Group · NY warn expedited_slower_than_standard expedited mean 168.0h exceeds standard mean 1.00d (24h) Northeast Health Partners (Regional Accountable Entity)
Northeast Health Partners · CO warn expedited_slower_than_standard expedited mean 25.9h exceeds standard mean 0.76d (18h) UnitedHealthcare Medicare Advantage - Contract H5652
UnitedHealth Group warn expedited_slower_than_standard expedited mean 24.0h exceeds standard mean 0.00d (0h) Community Health Choice CHIP & CHIP Perinatal (combined)
Community Health Choice · TX warn expedited_slower_than_standard expedited mean 288.0h exceeds standard mean 9.00d (216h) UnitedHealthcare Medicare Advantage - Contract H7833
UnitedHealth Group warn expedited_slower_than_standard expedited mean 24.0h exceeds standard mean 0.00d (0h) Aetna Better Health Kids (Pennsylvania CHIP)
CVS Health / Aetna · PA warn expedited_slower_than_standard expedited mean 51.1h exceeds standard mean 1.97d (47h) New York Child Health Plus
UnitedHealth Group · NY warn expedited_slower_than_standard expedited mean 96.0h exceeds standard mean 0.00d (0h)