Organization Detail
Blue Cross and Blue Shield of Minnesota
14 plans across 1 state · Medicare Advantage
Blue Cross and Blue Shield of Minnesota reported prior authorization metrics for 14 Medicare Advantage plans across 1 state under CMS rule CMS-0057-F for calendar year 2025. Across those plans, Blue Cross and Blue Shield of Minnesota processed 246,138 standard prior authorization requests. The average standard prior authorization denial rate was 4.9%, below the national average of 11.8%. When patients or providers appealed denied prior authorizations, 42.6% of appeals were overturned on average. Standard prior authorization decisions took an average of 1.8 days.
4.9%
Blue Cross and Blue Shield of Minnesota Denial Rate
standard, avg across 14 plans
11.8%
National Average
all reporting plans
-6.9%
vs. National
below average
MN14 plans
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Blue Cross Medicare Advantage Choice South (H5959-009)Medicare Advantage | 4,033 | 3,773 | 260 | 93.5% | 6.5% | 25 | 28.0% | 72.0% | 0.0% | 100.0% | 1.9 | 0.2 |
| Blue Cross Medicare Advantage Complete South (H5959-011)Medicare Advantage | 862 | 807 | 55 | 93.6% | 6.4% | 6 | 50.0% | 50.0% | 0.0% | 100.0% | 1.9 | 0.2 |
| SecureBlue (H2425-001)Medicare Advantage | 47,881 | 44,926 | 2,955 | 93.8% | 6.2% | 933 | 0.0% | 100.0% | 0.0% | 100.0% | 3.4 | 1.9 |
| Blue Cross Medicare Core South (H5959-012)Medicare Advantage | 641 | 604 | 37 | 94.2% | 5.8% | 4 | 50.0% | 50.0% | 0.0% | 100.0% | 1.6 | 0.2 |
| Blue Cross Group Medicare Advantage Standard, Plus, Value & Elite (H5959-807)Medicare Advantage | 3,009 | 2,845 | 164 | 94.5% | 5.5% | 12 | 25.0% | 75.0% | 0.0% | 100.0% | 1.4 | 0.0 |
| Blue Cross Group Medicare Advantage Classic, Select & Premier (H5959-801)Medicare Advantage | 1,880 | 1,783 | 97 | 94.8% | 5.2% | 7 | 14.3% | 85.7% | 0.0% | 100.0% | 1.5 | 0.2 |
| Blue Cross Medicare Core Metro & West (H5959-013)Medicare Advantage | 18,817 | 17,939 | 878 | 95.3% | 4.7% | 92 | 42.4% | 57.6% | 0.0% | 100.0% | 1.6 | 0.0 |
| Blue Cross Medicare Advantage Freedom Blue MA Only (H5959-018)Medicare Advantage | 7,618 | 7,283 | 335 | 95.6% | 4.4% | 25 | 52.0% | 48.0% | 0.0% | 100.0% | 1.5 | 0.0 |
| Blue Cross Medicare Comfort West (H5959-016)Medicare Advantage | 6,137 | 5,870 | 267 | 95.7% | 4.3% | 21 | 61.9% | 38.1% | 0.0% | 100.0% | 1.6 | 0.1 |
| Blue Cross Medicare Advantage Complete Metro & West (H5959-010)Medicare Advantage | 20,062 | 19,223 | 839 | 95.8% | 4.2% | 94 | 33.0% | 67.0% | 0.0% | 100.0% | 1.6 | 0.1 |
| Blue Cross Group Medicare Advantage Elite MAPD BCBSMN Retirees (H5959-809)Medicare Advantage | 1,596 | 1,530 | 66 | 95.9% | 4.1% | 5 | 60.0% | 40.0% | 0.0% | 100.0% | 1.6 | 0.1 |
| Blue Cross Medicare Choice Metro & West (H5959-014)Medicare Advantage | 118,617 | 113,775 | 4,842 | 95.9% | 4.1% | 538 | 42.6% | 57.4% | 0.0% | 100.0% | 1.6 | 0.0 |
| Blue Cross Medicare Comfort Metro (H5959-015)Medicare Advantage | 14,142 | 13,567 | 575 | 95.9% | 4.1% | 58 | 37.9% | 62.1% | 0.0% | 100.0% | 1.5 | 0.0 |
| Blue Cross and Blue Shield of Minnesota Platinum Blue (H2461)Medicare Advantage | 843 | 812 | 25 | 96.3% | 3.7% | 1 | 100.0% | 0.0% | 0.0% | 100.0% | 2.6 | 1.1 |