Denial Facts

Where independent external review goes unused

By Andrew at Axion Labs · August 19, 2026, updated September 5, 2026

Data verified September 5, 2026 · CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain

External review is free, decided by an organization your insurer does not control, and binding on the plan. Nationally it is used once for every 14,369 denials, and 32.8% of the reviews that happen are overturned. This page lists the insurers with the largest volume of denials, and shows against each how little that stage was used.

84,502,749
Claims denied nationally
5,881
External reviews filed
1 in 14,369
Denials reaching review
32.8%
Of those, overturned
50
Insurers with zero filed
Read the last column, not the first. A large denial count is a large book of business. A denial count of 8,326,461 across 50 insurer records against zero external reviews is something else: the one stage the insurer does not decide, and it went unused.

Largest denial volumes, with how rarely external review was reached

InsurerStateClaims deniedExternal reviewsDenials per review
Blue Cross Blue Shield of TexasTexas 11,028,737808 1 in 13,649
Health Options, Inc.Florida 10,507,969153 1 in 68,680
Blue Cross and Blue Shield of FloridaFlorida 4,251,990170 1 in 25,012
Blue Cross and Blue Shield of NCNorth Carolina 3,116,07188 1 in 35,410
Celtic Insurance CompanyTexas 2,652,607237 1 in 11,192
UnitedHealthcare of Texas, Inc.Texas 2,550,56067 1 in 38,068
Blue Cross and Blue Shield of AlabamaAlabama 2,038,60313 1 in 156,816
Blue Cross and Blue Shield of South CarolinaSouth Carolina 1,827,005234 1 in 7,808
Ambetter of Magnolia Inc.Mississippi 1,824,1950 none filed
SelectHealth, Inc.Utah 1,571,221119 1 in 13,204
Community Health Choice, Inc.Texas 1,449,31926 1 in 55,743
Blue Cross Blue Shield of OklahomaOklahoma 1,385,53750 1 in 27,711
Celtic Insurance CompanyArkansas 1,297,9800 none filed
Superior Health PlanTexas 1,287,30562 1 in 20,763
Scott and White Health PlanTexas 1,205,777170 1 in 7,093
Celtic Insurance CompanyMissouri 1,113,3850 none filed
HMO Louisiana, Inc.Louisiana 993,016247 1 in 4,020
Cigna Health and Life Insurance CompanyFlorida 926,08015 1 in 61,739
Oscar Insurance CompanyTexas 764,285517 1 in 1,478
Celtic Insurance CompanyKansas 734,16517 1 in 43,186
UnitedHealthcare of Florida, Inc.Florida 719,83218 1 in 39,991
USAble Mutual Insurance CompanyArkansas 669,70235 1 in 19,134
UnitedHealthcare of Arizona, Inc.Arizona 646,18133 1 in 19,581
CareSource Indiana, Inc.Indiana 638,511436 1 in 1,464
Blue Care Network of MichiganMichigan 630,29865 1 in 9,697
Florida Health Care Plan, Inc.Florida 602,77136 1 in 16,744
CareSource Ohio, Inc.Ohio 562,546263 1 in 2,139
Health First Commercial Plans, Inc.Florida 475,72237 1 in 12,857
Molina Healthcare of Florida, IncFlorida 341,2960 none filed
Oscar Buckeye State Insurance Corp.Ohio 337,922394 1 in 858
Healthy Alliance Life Co(Anthem BCBS)Missouri 295,8020 none filed
Medica Insurance CompanyNebraska 281,81911 1 in 25,620
QualChoice Life & Health Insurance Company, Inc.Arkansas 262,7310 none filed
Security Health Plan of Wisconsin, Inc.Wisconsin 247,1910 none filed
QCA Health Plan, Inc.Arkansas 245,7170 none filed
Molina Healthcare of Texas, Inc.Texas 237,12621 1 in 11,292
Blue Cross Blue Shield of Michigan Mutual Insurance CompanyMichigan 236,25778 1 in 3,029
Blue Cross and Blue Shield of Arizona, Inc.Arizona 233,016180 1 in 1,295
MOLINA HEALTHCARE OF SOUTH CAROLINA, INCSouth Carolina 230,1500 none filed
UnitedHealthcare of Ohio, Inc.Ohio 208,08921 1 in 9,909

Top 40 by volume of denials, of 100 insurer records reporting both figures. Source: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain.

States where not one denial reached external review

Alaska (239,313 denied) · Delaware (440,631 denied) · Hawaii (198,653 denied) · Mississippi (2,725,739 denied) · New Hampshire (321,334 denied) · North Dakota (140,595 denied) · South Dakota (112,411 denied) · Wisconsin (1,188,325 denied) · Wyoming (229,909 denied)

What this does and does not show. It does not show that any of these denials was wrong, nobody can say that about a review that never happened. It shows that the free, binding, independent stage of a two-stage federal appeal system is barely used, and that the people who do use it succeed 32.8% of the time. That gap is an information problem, which is the entire reason this site exists.
What we will not pretend.
Work out your two deadlines

The federal timeframes: 180 days from the date on the denial notice to file the internal appeal, then 4 months from the final internal denial to request independent external review. Put your date in and get the actual calendar dates, with the days remaining.

Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →

This page exists because of one gap, and that gap is the reason the site exists at all: the stage that actually overturns denials is free, binding on the plan, and used once for every 14,369 denials. Read the last column against the first. A large denial count can simply mean a large book of business. A large denial count with no independent reviews behind it is a different thing, and it is worth knowing which of the two sent your letter.

, Andrew at Axion Labs · hello@getaxionlabs.com
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Where these numbers come from

Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.

Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).

This page presents federal statistics and a general description of appeal rights created by federal law. It is not legal, medical, or insurance advice, and no outcome is guaranteed. Your denial letter and plan documents govern your specific case. Free help is available from your state's Consumer Assistance Program and from the federal Marketplace at HealthCare.gov.

How both appeals work → · All 185 insurer-state records →

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