Alliant Health Plans (Georgia) in-network claim denial rate: 8.1%

In the CMS Transparency in Coverage file for plan year 2024, Alliant Health Plans reported denying 36,987 of 455,071 in-network claims (8.1%) in Georgia, from 2022 claims. 11.2% of internal appeals were overturned (310 of 2,772). That is the 9th highest reported rate of 9 ranked issuers in Georgia; the state median is 17.7%.

Denial rate

8.1%

36,987 of 455,071 claims

Appeals overturned

11.2%

310 of 2,772 filed

External review overturned

n/a

n/a of 23 filed

Compared with Georgia and the national median

Measure	Alliant Health Plans	Georgia median	National median
In-network denial rate	8.1%	17.7%	15.5%
In-network claims received	455,071	—	—
Internal appeals filed	2,772	—	—
Internal appeal overturn rate	11.2%	45.3%	45.9%
External reviews filed	23	—	—
External review overturn rate	n/a	100.0%	64.1%
Out-of-network denial rate	27.0%	—	—

Medians are across issuers with at least 1,000 in-network claims received in the same file (Georgia: 9 issuers; national: 174 issuers in 32 states). Plan year 2024 file, 2022 claims.

Read these numbers carefully

Reporting lag: the CMS public-use file for a plan year reports claims from two plan years earlier (the PY2025 file carries 2023 claims). These are not this year's figures.
In-network only: the denial rate is in-network claims denied divided by in-network claims received. Out-of-network claims are shown separately where the issuer reported them.
"Denied" is broad: CMS counts every denial, including administrative denials, duplicate submissions, ineligibility, incorrect billing and partial denials, not only medical-necessity decisions.
Issuer level: CMS reports the counts once per issuer per state and repeats them on every plan row; plan-level counts, where present, list denials only, so no per-plan rate is computed.
Coverage: only issuers on the federally facilitated marketplace (HealthCare.gov states) report to this file. Employer plans, Medicare and Medicaid are not included.
No inference of intent: a higher rate can reflect the issuer's mix of claims, its billing rules or its membership as much as its coverage decisions. Compare with the state median and read the N.

Source: CMS Transparency in Coverage Public Use File (Health Insurance Exchange PUFs), plan year 2024; data dictionary. Issuer's own claims-payment policy page: https://alliantplans.com/members/understanding-my-insurance-transparency-information/.

If Alliant Health Plans denied your claim

A denial is a decision you can contest. Marketplace plans must give you at least 180 days to file an internal appeal and offer independent external review after it (45 CFR 147.136). The letter states your deadline.

Plans in this filing (48)

Where CMS lists plan-level denial counts they are shown; no plan-level rate is computed because the file does not give plan-level claims received.

Plan ID	Type	Metal	Plan-level denials (in-network)
83761GA0040002	PPO	Gold	3,944
83761GA0040017	PPO	Silver	9,803
83761GA0040330	PPO	Gold	1,626
83761GA0040331	PPO	Silver	4,885
83761GA0040355	PPO	Gold	128
83761GA0040358	PPO	Gold	400
83761GA0040369	PPO	Silver	249
83761GA0040373	PPO	Silver	465
83761GA0040377	PPO	Platinum	n/a
83761GA0040378	PPO	Gold	n/a
83761GA0040379	PPO	Silver	n/a
83761GA0040380	PPO	Platinum	n/a
83761GA0040381	PPO	Bronze Expanded	n/a
83761GA0040382	PPO	Bronze Expanded	n/a
83761GA0040383	PPO	Catastrophic	n/a
83761GA0040385	PPO	Bronze Expanded	n/a
83761GA0040386	PPO	Bronze Expanded	n/a
83761GA0040392	PPO	Catastrophic	n/a
83761GA0040393	PPO	Bronze Expanded	n/a
83761GA0040394	PPO	Platinum	n/a
83761GA0040395	PPO	Gold	n/a
83761GA0040396	PPO	Silver	n/a
83761GA0040397	PPO	Bronze Expanded	n/a
83761GA0040398	PPO	Platinum	n/a
83761GA0110003	HMO	Gold	280
83761GA0110004	HMO	Gold	150
83761GA0110008	HMO	Silver	1,295
83761GA0110009	HMO	Silver	4,939
83761GA0110019	HMO	Bronze Expanded	606
83761GA0110023	HMO	Catastrophic	44
83761GA0110024	HMO	Gold	n/a
83761GA0110025	HMO	Silver	n/a
83761GA0110027	HMO	Bronze Expanded	n/a
83761GA0110028	HMO	Platinum	n/a
83761GA0110030	HMO	Bronze Expanded	n/a
83761GA0110034	HMO	Platinum	n/a
83761GA0110035	HMO	Gold	n/a
83761GA0110036	HMO	Gold	n/a
83761GA0110038	HMO	Silver	n/a
83761GA0110039	HMO	Silver	n/a
83761GA0110040	HMO	Bronze Expanded	n/a
83761GA0110042	HMO	Bronze Expanded	n/a
83761GA0110046	HMO	Catastrophic	n/a
83761GA0110047	HMO	Platinum	n/a
83761GA0110048	HMO	Platinum	n/a
83761GA0110049	HMO	Gold	n/a
83761GA0110050	HMO	Silver	n/a
83761GA0110051	HMO	Bronze Expanded	n/a

Questions

What counts as a "denied" claim in Alliant Health Plans's 8.1% rate?

Every in-network claim the issuer reported as denied in the 2022 claims year, including administrative denials, duplicates, ineligibility, incorrect billing and partial denials, not only medical-necessity decisions. The figure is in-network claims denied divided by in-network claims received, exactly as reported to CMS.

Why is the data from 2022 when the file is for plan year 2024?

CMS's Transparency in Coverage public use file for a plan year reports claims data from two plan years earlier. This is the most recent issuer-level denial data CMS publishes for marketplace plans.

Does this predict whether my Alliant Health Plans claim will be denied?

No. It is an aggregate across all of the issuer's marketplace plans in Georgia. Your own claim depends on your plan, the service and the documentation. Compare the rate with the Georgia median (17.7%) and read the N before drawing conclusions.

How do I appeal a Alliant Health Plans denial?

Read the denial letter for the reason and the deadline, request the criteria and the claim file in writing, and file an internal appeal (at least 180 days on marketplace plans under 45 CFR 147.136). In the reporting year, 11.2% of internal appeals to this issuer were overturned (310 of 2,772). If the internal appeal fails, independent external review is available.

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Cite: Apellica Insurer Denial Report Cards, Alliant Health Plans (Georgia), plan year 2024, from the CMS Transparency in Coverage PUF. CC BY 4.0. Download the full table as CSV or read the methodology. Corrections: editorial@apellica.com.