03 · Validation
Every filing checked against itself
Rule
Severity
Hits
Catches
23
of 536 filings publish numbers that do not reconcile against themselves
119
publish percentages with no counts at all
139
publish no appeal outcome
340
total findings across 536 filings
expedited_slower_than_standard · 20 hits
expedited turnaround exceeding standard Show all 340Plan
Severity
Rule
Detail
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) Molina Healthcare of Texas CHIP Perinate MHT (at or below 185% FPL)
Molina Healthcare · TX warn expedited_slower_than_standard expedited mean 59.0h exceeds standard mean 1.00d (24h) Molina Healthcare of Texas CHIP Perinate RSA (at or below 185% FPL)
Molina Healthcare · TX warn expedited_slower_than_standard expedited mean 53.0h exceeds standard mean 2.00d (48h) Senior Whole Health of New York - MLTSS
Molina Healthcare · NY warn expedited_slower_than_standard expedited mean 79.0h exceeds standard mean 3.00d (72h)