How the Index reviews prior authorization reporting
The Prior Auth Index tracks public prior authorization transparency reporting across U.S. health plans, including publication status, source availability, machine-readable access, and reporting usability.
What the Index tracks
The Index reviews publicly available prior authorization reporting sources associated with impacted health plans and payer entities. The review focuses on whether required reporting appears to be publicly available, whether a source URL is accessible, whether the reporting is machine-readable, and whether the published information is usable for comparison or analysis.
The Index is designed as a source-level reporting reference. It does not determine individual coverage, medical necessity, claim outcomes, or whether a specific authorization request should be approved or denied.
Publication status
A plan or payer is treated as published when a public source appears to provide prior authorization transparency reporting associated with that entity or reporting group. Publication status reflects source availability at the time of review.
A plan or payer may be marked not published when no public source is identified, when a listed source is unavailable, or when the available page does not appear to contain the relevant prior authorization transparency reporting.
Machine-readable availability
Machine-readable availability refers to whether the reporting is provided in a format that can reasonably be parsed, extracted, or analyzed without manual reconstruction. Structured files, accessible tables, and clearly formatted datasets are generally more usable than scanned PDFs, image-based documents, broken files, or pages that require extensive manual interpretation.
Machine-readable status is separate from publication status. A payer can publish prior authorization reporting while still providing the information in a format that is difficult to compare, extract, or reuse.
Source review
Source URLs are reviewed for public accessibility, relevance to prior authorization transparency reporting, and connection to the payer or plan being tracked. Some sources may cover multiple related plans, contracts, subsidiaries, or reporting entities.
When multiple plans reference the same underlying disclosure, the Index may preserve plan-level entries while also noting that a single source can represent more than one reporting entity.
Reporting usability
Publication alone does not establish usability. The Index distinguishes between whether reporting exists and whether it is complete, accessible, source-linked, machine-readable, and meaningful for comparison across plans.
Usability issues may include missing metrics, inconsistent definitions, inaccessible files, nonstandard formats, duplicate reporting structures, or disclosures that are difficult to compare across payer entities.
Limitations
The Index is based on publicly available reporting sources and may not reflect internal payer data, unpublished reporting, corrected disclosures not yet identified, or changes made after the most recent review.
The Index should be used as a public reporting reference, not as a legal, regulatory, medical, or coverage determination.
Updates and corrections
The Index is updated as new public reporting sources are identified, reviewed, or corrected. Publication status, machine-readable status, and source URLs may change as payer reporting pages are updated.
Source corrections, missing disclosures, and reporting updates can be sent through the contact page.
Found a missing source or reporting update?
Send source corrections, missing disclosures, or public reporting updates for review.
Contact the Index