Organization Detail
Healthfirst
9 plans across 1 state · CHIPMedicaid MCOMedicare Advantage
13.0%
Healthfirst Denial Rate
standard, avg across 9 plans
12.7%
National Average
all reporting plans
+0.3%
vs. National
near average
NY9 plans
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Source |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Healthfirst Child Health PlusCHIP | 28,487 | 20,433 | 8,054 | 71.7% | 28.3% | 869 | 3.1% | 96.9% | 0.0% | 100.0% | 2.1 | 1.0 | View source ↗ |
| Healthfirst Medicaid Managed CareMedicaid MCO | 750,763 | 603,021 | 147,742 | 80.3% | 19.7% | 12,073 | 14.3% | 85.7% | 0.3% | 99.7% | 1.6 | 0.0 | View source ↗ |
| Healthfirst HARPMedicaid MCO | 54,478 | 46,120 | 8,358 | 84.7% | 15.3% | 958 | 21.1% | 78.9% | 0.3% | 99.7% | 1.6 | 0.0 | View source ↗ |
| Healthfirst MLTCMedicaid MCO | 30,359 | 26,471 | 3,888 | 87.2% | 12.8% | 309 | 10.4% | 89.6% | 0.0% | 100.0% | 2.1 | 0.0 | View source ↗ |
| Healthfirst Medicare (H9678)Medicare Advantage | 11,134 | 9,989 | 1,145 | 89.7% | 10.3% | 166 | 92.8% | 7.2% | 0.0% | 100.0% | 1.5 | 0.0 | View source ↗ |
| Healthfirst Medicare (H5989)Medicare Advantage | 52,494 | 47,266 | 5,228 | 90.0% | 10.0% | 507 | 90.3% | 9.7% | 0.0% | 100.0% | 1.4 | 0.0 | View source ↗ |
| Healthfirst Medicare (H1722)Medicare Advantage | 3,316 | 2,998 | 318 | 90.4% | 9.6% | 49 | 95.9% | 4.1% | 0.0% | 100.0% | 1.7 | 0.0 | View source ↗ |
| Healthfirst Medicare HMO (H3359)Medicare Advantage | 764,446 | 701,699 | 62,747 | 91.8% | 8.2% | 7,292 | 85.9% | 14.1% | 0.0% | 100.0% | 1.5 | 0.0 | View source ↗ |
| Healthfirst Medicaid Advantage Plus (Medicaid-Only Services)Medicaid MCO | 70,748 | 68,477 | 2,271 | 96.8% | 3.2% | 0 | — | — | 0.0% | 100.0% | 2.0 | 0.0 | View source ↗ |