Analytics
Operating metrics required by CMS-0057-F. Public-reporting fields covered automatically.
85.3%
Auto-approval rate▲ 2.3 pts
36 min
Avg turnaround (P50)▼ 11 min
38.4h
P95 turnaround▼ 4.2h
74%
Appeal overturn rate▲ 6 pts
Case volume — last 30 days
3,331 total
04-09
04-14
04-19
04-24
04-29
05-04
Approval rate by payer
UHC
85.1%
n=228
Anthem
89.5%
n=228
Cigna
78.1%
n=228
Aetna
85.1%
n=228
Humana
91.2%
n=227
BCBS IL
85.5%
n=227
Centene
75.8%
n=227
Kaiser
92.1%
n=227
Approval rate by service category
Imaging
93.4%
n=152
DME
84.9%
n=152
Cardiology
84.9%
n=152
GI
94.7%
n=152
Specialty pharmacy
84.9%
n=152
Genetic testing
81.6%
n=152
Endocrine / weight
61.8%
n=152
MSK / Surgical
79.6%
n=152
Oncology — imaging
86.1%
n=151
Oncology — drug
96.0%
n=151
Sleep
84.1%
n=151
Behavioral health
91.4%
n=151
Top denial reasons
47
Conservative therapy duration insufficient
38
Missing biomarker / lab result
33
Step therapy not completed
28
Imaging within recent window already on record
24
Functional measure not documented (ODI / PHQ-9)
19
Smoking cessation duration insufficient (elective surgery)
14
Medical necessity — no ACC/AHA AUC alignment
11
Member ineligible / coverage lapsed
Gold-card candidates
Provider
NPI
CPT
Approval rate
Chinedu Okonkwo, MD
1689345712
72148
97.0%
Marcos Garcia, MD
1922088901
93351
95.0%
Wei Zhang, MD
1538196274
J9271
94.0%
Daniel Kim, DO
1567890123
22633
92.0%
Lucia Franco, MD
1456789012
90867
96.0%
Anjali Patel, MD
1376633768
27447
93.0%
CMS-0057-F readiness
7-day standard decision compliance
Standard PA decisioned within 7 calendar days
99.8%
72-hour urgent decision compliance
Expedited PA decisioned within 72 hours
99.7%
Denial-reason specificity coverage
Every denial cites specific clinical criterion + policy
100.0%
Public reporting fields covered
Annual public reporting metrics generated automatically
100.0%