State Detail
Kansas
3 plans reporting · CY 2025
Across 3 plans reporting in Kansas, standard prior authorization denial rates range from 3.0% to 25.5%, averaging 10.6%. Among plans reporting appeal outcomes, 61.9% of appealed denials are overturned. All data is from mandatory CMS-0057-F disclosures for calendar year 2025.
Plan Comparison
| Standard | Expedited | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Plan | Org | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Requests | Approved | Denied | Appr % | Denial % | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Source |
| Blue Cross Blue Shield of Kansas | ||||||||||||||||||||||||||
| Blue Cross Blue Shield of Kansas QHPExchange Plans | Blue Cross Blue Shield of Kansas | 3,998 | 3,854 | 136 | 96.4% | 3.4% | 101 | 58.4% | 33.7% | 0.0% | 0.0% | 8.0 | 8.0 | 1 | 1 | 0 | 100.0% | 0.0% | 0 | — | — | 0.0% | 0.0% | 2.1 | 2.0 | View source ↗ |
| Blue Cross Blue Shield of Kansas Medicare Advantage (H7063)Medicare Advantage | Blue Cross Blue Shield of Kansas | 1,974 | 1,910 | 64 | 97.0% | 3.0% | 4 | 75.0% | 25.0% | 0.0% | 0.0% | 5.8 | 5.6 | 88 | 86 | 2 | 98.0% | 2.0% | 0 | — | — | 0.0% | 0.0% | 1.7 | 1.2 | View source ↗ |
| Centene Corporation | ||||||||||||||||||||||||||
| Ambetter from Sunflower HealthExchange Plans | Centene Corporation | 64,114 | 47,752 | 16,362 | 74.5% | 25.5% | 1,702 | 52.4% | 47.6% | 0.1% | 99.9% | 5.0 | 2.0 | 1,628 | 1,344 | 284 | 82.6% | 17.4% | 111 | 71.2% | 28.8% | 0.6% | 99.4% | 1.0 | 0.0 | View source ↗ |
Standard Denial Rates by Plan
Appeals Analysis
Plans in the upper-right deny frequently and have high overturn rates — suggesting inappropriate denials.
Similar Denial Rates