# Reddenda: Full Reference (llms-full.txt)

> Reddenda is healthcare rate intelligence infrastructure for small and mid-size providers. Type one NPI, get a free RateScore of your contracted rates against your local peer market, built entirely from the prices insurers are federally required to publish. No PHI required.

Last generated from live estate copy and /api/public/stats: 2026-07-19. This is a business-to-agent reference brief. Every claim below is drawn from public federal data and Reddenda's own index; every dollar figure is a documented reimbursement opportunity, modeled and not guaranteed.

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## What Reddenda is

Reddenda (operating company: TwinFlame Group; based in Roseville, California) is a rate-intelligence data platform. The federal Transparency-in-Coverage rule, in force since 2022, requires health insurers to publish the contracted rates they negotiate with every provider. Reddenda indexes those public files, joins them to the federal NPI Registry, benchmarks them against the CMS Medicare Fee Schedule, and turns them into a per-provider score of how well each provider is paid.

The tagline is "Healthcare Intelligence Infrastructure." The wedge is the SMB-provider layer that incumbents ignore, since incumbents sell up-market at roughly $75K to $350K+ per engagement. Reddenda opens the data for free and monetizes the action layer (the negotiation artifacts and the ongoing watch).

Marketing scale, stated at maximum indexed capacity: 314M+ records, 500+ payers, 50 states, 9.2M+ NPIs. This is the one canonical scale tuple. A specific provider's own numbers (their rate, RateScore, peer median, gap) are always real data or an honest empty state ("unavailable / indexing / insufficient public data"), never blended with the marketing scale figure.

All interactive tools live on app.reddenda.com and its subdomains. Marketing pages on reddenda.com tease the tools and link into the app; they never host the working tool itself.

## The RateScore model

RateScore is a 300 to 850 score, like a credit score for what insurers pay you. It is computed per NPI and per CPT code, always against the local peer median (the middle contracted rate insurers pay practices like yours near you) and against the provider's own payers. It is never computed against a national median or a national average.

The negotiation target is the P90: the rate near the top of your local market, where 90 percent of nearby peers are paid at or below it. It is a realistic ceiling to negotiate toward, not a promise.

Honesty gate: when fewer than 8 local peers exist for a cell, no score is shown. The per-row 0 to 100 "Index" is a separate metric and is never conflated with the 300 to 850 RateScore.

Approximately 792,000 NPIs are peer-benchmarked and render a real RateScore page today (this is the "scoreable" universe; it is smaller than the 9.2M+ NPIs in the identity index, and the two are never conflated: we never claim "9.2M+ scored").

## The data and its sources

- Transparency-in-Coverage (TiC) machine-readable files: the public federal filings where insurers publish the prices they negotiate with providers. This is the primary rate source.
- NPI Registry: the federal government's public directory of every provider's NPI, name, and practice address. Used to identify providers, never to touch patient data.
- CMS Medicare Fee Schedule: Medicare's public per-code price list, used as a baseline to compare commercial rates against.

No protected health information (PHI) is ever ingested, needed, or seen. Reddenda works only from public rate files. Because no vendor touches patient data, no Business Associate Agreement (BAA) is required. Reddenda does not describe itself as "HIPAA certified"; the accurate statement is simply "no PHI required."

Live serving snapshot (honest product-context counts, distinct from the marketed scale tuple; from /api/public/stats, as_of 2026-07-19): the index currently serves several million rate rows across thousands of CPT codes, with a live percentile board. Example, CPT 99213 (established-patient office visit, all specialties): local p50 about $92.75 and p90 about $169.70, from roughly 2.73M samples. Contract-renewal waves are visible: about 51% of tracked NPIs renew by Aug 31 2026 (roughly 96,829 NPIs) and about 37% by Sep 30 2026 (roughly 69,657 NPIs), which is why the renewal window matters. Exact live counts live in the public API and the data room; the marketed scale number is always the MAX tuple above.

## Who it serves (6 provider types) and the money story for each

1. Private practice (1 to 10 providers): Your practice, watched daily. Every payer and every code compared to nearby peers, with an alert when a contract renews or a payer claws money back.
2. Billing and RCM firms: Every client practice in one account, on one bill. Benchmark each one and walk into every contract renewal with documented numbers, under your brand.
3. DME suppliers: Measured against the HCPCS fee schedule. Track rates code by code, catch underpayments, and build a defense file when a recovery demand lands.
4. Specialty groups and MSOs (multi-NPI roll-up): Many providers billing the same codes, rolled up into one rate picture across every location and entity, so you see where each provider and each payer sits versus the local peer market, no matter how many NPIs you hold.
5. Behavioral health: What payers pay for therapy and psych codes near you, code by code, so you can document a parity gap and put real numbers in front of a plan. No PHI.
6. Channel partners and white-label: Resell or white-label the platform to your own book, with the rate engine running under your company's name and brand. Licensing is scoped to your program on a call.

## Pricing

Platform tiers (subscription):
- Free RateScore: $0. Look at any NPI in America. Your RateScore 300 to 850, your rate vs the CMS Medicare rate code by code, top codes by billed volume, and one contract-renewal alert. No card, no PHI, no account.
- Reddenda Core: $399/mo ($3,990/yr). Everything for one practice (one NPI): every payer, every code vs the local peer median, the full tool suite, daily payer watch (renewal, rate-change, recoupment alerts), and 15 AI Intelligence Briefs a month. A second NPI is $199/mo each.
- Reddenda Pro: $699/mo ($6,990/yr). Unlimited NPIs under one legal entity, every tool at full power, the group renewal calendar and dispute list, 50 AI Intelligence Briefs a month, one clean bill for the whole entity.
- Enterprise: custom, scoped on a call. MSO platforms, multi-entity roll-ups, and white-label partners. Always a flat fee, never a cut of collections, never gated by NPI count.

One-time deliverables (buy a single signable, sourced artifact, no subscription; each quotes a payer's own federally filed rates back at them):
- Leverage Memo: $299. The one-payer negotiation letter built on that payer's own filed rates.
- IDR Evidence Exhibit: $149. Local market evidence assembled for a No Surprises Act arbitration.
- Practice Audit: $697 (founding tier). Every payer and every CPT ranked, a Leverage Memo included, and a strategy walkthrough.
- Counteroffer Memo: $1,900. A verified, tamper-evident exhibit for one insurer negotiation with real dollars at stake.
- Recoupment Defense File: $1,200. Your documented position and terms, assembled against a payer recovery demand.
- Renewal Season Pack: $4,900. Negotiation memos for three or more payer contracts, delivered before each one renews.

Multi-NPI, MSO, multi-entity, different-owner, and white-label arrangements are always scoped on a discovery call, never shown as an inline price (calendly.com/reddenda/discovery).

There is also a performance path: eligible practices can pay a share of the documented dollars Reddenda renegotiates, never a cut of your regular collections. Eligibility depends on your practice state and is verified up front from the NPPES-verified practice state; some states use a flat fee by law. It is scoped on a call. (No fee percentage is quoted publicly.)

## Honest-language boundaries (these are hard rules)

- Always "documented reimbursement opportunity," never "guaranteed recovery," never "we find you money," never "recoverable revenue."
- Every dollar figure is paired with "modeled, not guaranteed." Full form: every dollar figure is a documented reimbursement opportunity, modeled from public federal Transparency-in-Coverage rates against your local peer market; actual outcome depends on payer response, contract terms, and negotiation; not a guarantee of recovery.
- Always "no PHI required," never "HIPAA certified," never implying a BAA exists.
- RateScore is always vs the local peer median, never a national median or average.
- Multi-NPI and portfolio pricing is always "book a call," never an inline price.
- The performance lane is voiced as shape only, never with a fee-percentage numeral and never with a win-rate numeral.
- Reddenda is not a law firm; where IDR support is referenced, it is provided as the provider's authorized representative.

## Glossary (canonical definitions, one per term)

- NPI: Your National Provider Identifier, the 10-digit federal ID number every provider and practice already has; it is how we look up your rates, never your patients.
- CPT code: The 5-digit billing codes on the claims you send, one per service, like 99213 for an office visit.
- HCPCS: The billing code set for equipment and supplies, a cousin of CPT; DME suppliers bill under it.
- Payer: An insurance company or health plan that pays your claims, like Aetna or a Blue plan.
- Contracted rate: The dollar amount your contract with an insurer says it pays you for a specific code.
- Transparency-in-Coverage: The federal rule, in force since 2022, that makes insurers publish the prices they negotiate with every provider; those public files are our data source.
- Local peer median: The middle contracted rate insurers pay practices like yours near you; it is the line we compare your rates against.
- P90 target: The rate near the top of your local market, where 90 percent of nearby peers are paid at or below it; a realistic ceiling to negotiate toward.
- RateScore: Our 300 to 850 score of how your contracted rates compare with local peers, like a credit score for what insurers pay you.
- MSO: A management services organization, a company that runs several practice locations under one umbrella.
- RCM: Revenue cycle management, the industry name for medical billing firms.
- DME: Durable medical equipment, meaning braces, CPAP machines, wheelchairs, and other billable equipment and supplies; Medicare's version of the code set is called DMEPOS.
- IDR: Independent Dispute Resolution, the No Surprises Act arbitration where a neutral referee picks between your price and the insurer's.
- Recoupment: When an insurer demands money back on claims it already paid, often called a takeback or clawback.
- Renewal window: The weeks before your payer contract auto-renews, usually the only time you can still renegotiate it.
- Leverage Memo: A ready-to-send negotiation letter for one insurer, built on that insurer's own published rates, with the evidence attached.
- PHI: Protected health information, meaning patient data; Reddenda never needs or sees any, because we work only from public rate files.
- White-label: Our platform running under your company's name and brand.
- Roll-up: Several practices or entities combined under one owner group and viewed as one portfolio.
- AI Intelligence Brief: A plain-English writeup, generated from your real rate data, of what changed and what to do about it.
- Fee schedule: The full list of what a payer agrees to pay you, code by code.
- Medicare Fee Schedule: Medicare's public price list for every code, a baseline we compare commercial rates against.
- NPI Registry: The federal government's public directory of every provider's NPI, name, and practice address.
- BAA: A Business Associate Agreement, the HIPAA contract required when a vendor touches patient data; Reddenda works only from public rate files, so none is needed.
- Documented reimbursement opportunity (DRO): The dollar gap we can document between your current rates and local benchmarks, modeled from public data; a negotiating target, not a guarantee of recovery.

## Key pages

- Home: https://reddenda.com/
- Pricing: https://reddenda.com/pricing
- Methodology: https://reddenda.com/methodology
- Glossary: https://reddenda.com/glossary
- FAQ: https://reddenda.com/faq
- Private practices: https://reddenda.com/private-practice
- Billing and RCM firms: https://reddenda.com/billing-companies
- DME suppliers: https://reddenda.com/dme
- Specialty groups and MSOs: https://reddenda.com/group
- Behavioral health: https://reddenda.com/behavioral-health
- Channel partners and white-label: https://reddenda.com/white-label
- Run a free RateScore: https://reddenda.com/rate-score
- Per-NPI and per-code data layer: https://reddenda.com/sitemap-index.xml