State Detail
Montana
1 plan reporting · CY 2025
Across 1 plan reporting in Montana, standard prior authorization denial rates range from 10.0% to 10.0%, averaging 10.0%. Among plans reporting appeal outcomes, 80.5% 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 |
| Health Care Service Corporation | ||||||||||||||||||||||||||
| BCBS Montana Medicare Advantage (HCSC)Medicare Advantage | Health Care Service Corporation | — | — | — | 90.0% | 10.0% | — | 80.5% | 19.5% | — | — | 1.7 | 0.8 | — | — | — | 84.0% | 16.0% | — | — | — | — | — | 1.6 | 1.3 | 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