Prior Authorization Metrics Reporting

The Centers for Medicare & Medicaid Services (CMS) has established a multi-step framework to support interoperability across the healthcare system. These standards are intended to ensure the secure electronic exchange of health information, helping providers coordinate care, support public health initiatives, and improve access to electronic medical records.

This report fulfills one component of those requirements and is tied to participation in the Medicare and Medicaid programs. Sharing this information reflects NHP’s commitment to transparency, accountability, and the effective use of health technology in the communities we serve.

This annual report summarizes the prior year’s denial rates and appeal overturn rates.