Market Access Dashboard
Total Payers
6
Total Plans
12
Avg Approval Rate
71.2%
Avg Denial Rate
28.8%
Active Alerts
5
Unack'd High Severity
2
Total Playbooks
5
Total Policy Docs
10
Denial Trend (Last 6 Months)
- Avoidable
- Total Denials
Formulary Coverage Distribution
- non preferred
- preferred
- prior auth required
- specialty
Payer Risk Index
Centene
Aetna
Blue Cross Blue Shield
Cigna
UnitedHealthcare
Humana
Top Access Barriers
Recent Unacknowledged Alerts
| Event Type | Description | Severity | Date |
|---|---|---|---|
| formulary_change | Aetna moved Keytrevala from Tier 3 to Tier 4 (non-preferred) effective March 2025 | HIGH | Apr 13, 2026 |
| new_restriction | BCBS added 3-step therapy requirement for biologic drugs in rheumatology | HIGH | Apr 13, 2026 |
| pa_criteria_update | Centene simplified Medicaid PA requirements — reduced required documents from 5 to 3 | LOW | Apr 13, 2026 |
| new_restriction | Aetna added quantity limit for infusion drugs: max 4 infusions per 28-day cycle | MEDIUM | Apr 13, 2026 |
| tier_change | Cigna moved Keytruda from Tier 5 to Tier 4 for select indications | MEDIUM | Apr 13, 2026 |