Evidence file · claims-moda-health-plan-inc-ak-hios-73836-2024
Moda Health Plan, Inc.
HIOS 73836 · Marketplace · 2024 · Alaska
The takeaway
What this record says—and what it does not
This issuer reported denying 17.3 of every 100 in-network Marketplace claims in this reporting unit during 2024.
- Compared with what?
- That is below the 19.0% median among 158 records in this library with the same program, year, and metric. This is a directional comparison, not a quality grade.
- How could I use this?
- Use this rate to ask how the issuer compares with like Marketplace issuers, to identify outliers for reporting or oversight, or to frame questions about its claims practices.
- What can’t I conclude?
- It does not show whether your claim was correctly decided, why a service was denied, or what happened in employer, Medicare, or Medicaid plans.
- Claims received
- 168,684 count
- Claims denied
- 29,231 count
- Claims denied
- 17.3%
- Appealed denials reversed
- 48.6%
Scope and limits
- Family
- claims
- Scope
- Issuer × state; HealthCare.gov Marketplace; in-network medical claims
- Status
- published
- Missing fields
- None identified in normalized fields
Artifact and version
- Captured
- 2026-07-17T21:57:18.595Z
- SHA-256
- 8dd5e05c15e690be4ac2abdbc5695835a728146c46b85f453657c504c71f4241
- Version
- 8dd5e05c15e6
- Extraction
- Parsed from the checked source extraction and normalized by pipeline v1.
Citation and files
Moda Health Plan, Inc. (AK), HIOS 73836, 2024 Marketplace claims transparency record.
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