Organization Detail
Blue Cross Blue Shield of Arizona
2 plans across 1 state · Medicare AdvantageExchange Plans
Blue Cross Blue Shield of Arizona reported prior authorization metrics for 2 Medicare Advantage, Exchange Plans plans across 1 state under CMS rule CMS-0057-F for calendar year 2025. Across those plans, Blue Cross Blue Shield of Arizona processed 71,644 standard prior authorization requests. The average standard prior authorization denial rate was 9.2%, below the national average of 11.8%. When patients or providers appealed denied prior authorizations, 68.1% of appeals were overturned on average. Standard prior authorization decisions took an average of 2.8 days.
9.2%
Blue Cross Blue Shield of Arizona Denial Rate
standard, avg across 2 plans
11.8%
National Average
all reporting plans
-2.6%
vs. National
below average
AZ2 plans
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona ACA Individual PlansExchange Plans | 34,329 | 29,927 | 4,402 | 87.2% | 12.8% | 363 | 45.2% | 54.8% | 0.1% | 99.9% | 3.5 | 0.3 |
| Blue Cross Blue Shield of Arizona Medicare AdvantageMedicare Advantage | 37,315 | 35,217 | 2,098 | 94.4% | 5.6% | 477 | 91.0% | 9.0% | 0.1% | 100.0% | 2.1 | 0.5 |