State Detail
Mississippi
9 plans reporting · CY 2025
Across 9 plans reporting in Mississippi, standard prior authorization denial rates range from 3.7% to 21.5%, averaging 13.1%. Among plans reporting appeal outcomes, 37.8% 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 |
| Aetna/CVS Health | ||||||||||||||||||||||||||
| Aetna Better Health LA MA (H3239)Medicare Advantage | Aetna/CVS Health | — | — | — | 89.6% | 10.4% | — | 84.7% | 15.3% | — | — | 1.7 | 0.0 | — | — | — | 85.3% | 14.7% | — | — | — | — | — | 0.4 | 0.0 | View source ↗ |
| Blue Cross Blue Shield of Mississippi | ||||||||||||||||||||||||||
| Blue Cross Blue Shield of MississippiExchange Plans | Blue Cross Blue Shield of Mississippi | — | — | — | 79.5% | 20.5% | — | 0.9% | 99.1% | 6.3% | 93.7% | 3.7 | 4.0 | — | — | — | 94.8% | 5.2% | — | — | — | — | — | 0.8 | 0.2 | View source ↗ |
| Centene Corporation | ||||||||||||||||||||||||||
| Ambetter from Magnolia HealthExchange Plans | Centene Corporation | 91,950 | 72,160 | 19,790 | 78.5% | 21.5% | 1,120 | 33.8% | 66.2% | 0.7% | 99.3% | 2.0 | 1.0 | 3,356 | 2,695 | 661 | 80.3% | 19.7% | 140 | 91.4% | 8.6% | 0.9% | 99.1% | 1.0 | 0.0 | View source ↗ |
| Magnolia Health Plan MedicaidMedicaid MCO | Centene Corporation | 104,537 | 85,469 | 19,068 | 81.8% | 18.2% | 753 | 48.6% | 51.4% | 3.5% | 96.5% | 1.0 | 1.0 | 943 | 758 | 185 | 80.4% | 19.6% | 12 | 83.3% | 16.7% | 6.3% | 93.7% | 1.0 | 0.0 | View source ↗ |
| Mississippi True Care MedicaidMedicaid MCO | Centene Corporation | 34,380 | 29,726 | 4,654 | 86.5% | 13.5% | — | 23.0% | 77.0% | 0.0% | 100.0% | 1.0 | 1.0 | 989 | 938 | 51 | 94.8% | 5.2% | — | 17.0% | 83.0% | 0.0% | 100.0% | 0.8 | 0.8 | View source ↗ |
| Mississippi Division of Medicaid | ||||||||||||||||||||||||||
| Mississippi Medicaid (FFS)Medicaid FFS | Mississippi Division of Medicaid | 60,252 | 52,480 | 6,119 | 87.1% | 10.2% | 991 | 72.7% | 22.3% | — | — | 3.1 | 1.0 | 39 | 32 | 6 | 82.0% | 15.4% | 2 | 100.0% | 0.0% | — | — | 4.6 | 1.1 | View source ↗ |
| Molina Healthcare | ||||||||||||||||||||||||||
| Molina Healthcare of MississippiExchange Plans | Molina Healthcare | — | — | — | 87.0% | 13.0% | — | 50.0% | 50.0% | 53.0% | 47.0% | 5.0 | 4.0 | — | — | — | 90.0% | 10.0% | — | 46.0% | 54.0% | 57.0% | 43.0% | 1.0 | 1.0 | View source ↗ |
| Molina Healthcare of MississippiMedicaid MCO | Molina Healthcare | — | — | — | 93.3% | 6.7% | — | 26.3% | 73.7% | 57.2% | 42.8% | 3.0 | 2.3 | — | — | — | 92.7% | 7.3% | — | — | — | — | — | 1.1 | 1.0 | View source ↗ |
| UnitedHealth Group | ||||||||||||||||||||||||||
| UnitedHealthcare of Mississippi (MississippiCAN Medicaid)Medicaid MCO | UnitedHealth Group | — | — | — | 96.3% | 3.7% | — | 0.2% | 99.8% | 0.1% | 99.9% | 0.1 | 0.0 | — | — | — | 95.6% | 4.4% | — | — | — | — | — | 0.0 | 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