Since 2022, federal law lets a provider take an underpaid out-of-network claim to binding arbitration. Roughly 2.6 million disputes were filed in 2025 alone, and providers won 88% of the decisions. The law tells the arbitrator exactly what to weigh: the provider's own contracted-rate history and local market share. That is our database.
45 CFR §149.510(c)(4)(iii)(B): the certified arbitrator must consider the contracted rates between that provider and that plan during the previous 4 plan years, and the market share held by the provider or the plan in the geographic region. Reddenda's index is built from the public record of exactly those two things.
Honest footnote: the 88% is the aggregate CMS rate, and it is driven by sophisticated repeat filers — the ten largest initiating parties file roughly 70% of all disputes and win at 82–95%. That is precisely the point. Winning is an evidence discipline, the biggest filers industrialized it, and the long tail of independent practices has had no instrument. Nothing on this page is a guarantee of any outcome.
Every dispute turns on the same question: what should this claim have paid? The payer answers with the QPA, its own median of its own rates. The arbitrator is instructed not to double-count it — and is required to consider what the provider submits about the factors the QPA cannot contain.
The rates between that provider and that plan over the previous four plan years. Reddenda's index is built from the public Transparency-in-Coverage record of contracted rates — per NPI, per code, per payer — and every new filing compounds it.
The market share held by the provider or the plan in the geographic region. Our engine already computes local peer distributions for every score it issues; the same machinery renders the market-share exhibit for the region in dispute.
The one-sentence version: federal law made the winning evidence a matter of public record, and Reddenda is the engine that reads that record. The exhibit a $75,000-a-year enterprise platform would assemble for a hospital, we produce for an independent practice — certified, tamper-evident, and priced like a filing fee.
Our covenant: Reddenda has never taken a dollar from a payer, and never will. Every exhibit we build is built for one side of the table. Read the covenant →
Run any NPI. The engine holds the public contracted-rate record and computes the local peer distribution for the region and codes in dispute. Looking is free, and no PHI is ever required.
Run a free rate card →A certified, tamper-evident evidence exhibit prepared for IDR submission: your current contracted-rate position and the local market-share exhibit, source-cited to the public federal filings, structured to the factors the arbitrator must weigh.
IDR Evidence Exhibit · $149 per disputeFor qualifying practices and billing companies we build the evidence book across the whole dispute pipeline and price it as a share of documented recovery — only where state law permits a performance fee, and always flat-fee in states where it does not. Scoped on a call, closed with a signed engagement letter.
Share of documented recovery · by state lawEvery input below is a published CMS figure or is derived from one, and the derivation is shown. The addressable segment is the long tail the industrialized filers ignore: the ~30% of dispute volume filed outside the ten largest initiating parties.
| Layer | Basis | At 10% take | At 15% take | At 25% take |
|---|---|---|---|---|
| Whole market (ceiling) | ~2.6M disputes/yr · 88% win · $2.2–2.8B/yr in awards | $220–280M/yr | $330–420M/yr | $550–700M/yr |
| Addressable long tail | ~780K disputes/yr outside the top-10 filers · $650–850M/yr in awards | $65–85M/yr | $100–130M/yr | $165–215M/yr |
Modeled from CMS-published dispute volumes and measured award flows (Georgetown CHIR analysis of CMS public use files). These are market-size layers, not revenue projections or guarantees; capture depends on execution, state-law eligibility for performance fees, and win outcomes that are never guaranteed. The exhibit itself is also sold flat-fee at $149 per dispute, so the engine earns in both lanes.
One free viral wedge feeds a flat-fee ladder; the ladder feeds the evidence engine; every exhibit and every score compounds the same index. The platform layer — the mass rate-data infrastructure — is the moat under all of it.
The honest spine: every dollar figure on this page is a documented, modeled figure from public federal data, never a guaranteed recovery. The 88% is the aggregate CMS determination rate for H1 2025, not a promise about any dispute. Performance fees are offered only where state fee-splitting law permits them; New York, Illinois, and North Carolina are always served flat-fee. Eligibility is verified server-side against the NPPES practice record. No PHI is required for any of it.