# Reddenda

> Healthcare rate intelligence infrastructure for SMB providers: type one NPI, get a free RateScore (300 to 850) of your contracted rates against the local peer median, built from the prices insurers publish under the federal Transparency-in-Coverage rule. No PHI required.

Reddenda (operating company TwinFlame Group, Roseville CA) indexes the rates insurers are federally required to publish and scores what each provider is paid, per NPI and per CPT, against the local peer market. Marketed scale: 314M+ records, 500+ payers, 50 states, 9.2M+ NPIs. Every dollar figure is a documented reimbursement opportunity, modeled and not guaranteed. Tools live on app.reddenda.com; marketing pages tease and link into them.

## What it is
- [Reddenda home](https://reddenda.com/): Healthcare rate intelligence. Your payers published your rates, and the date they reset; we indexed them and score yours.
- [Methodology](https://reddenda.com/methodology): How the rate index is built and verified. Sources (TiC filings, NPPES, CMS fee schedules), the scoreable-cell gate, the RateScore 300 to 850 model, and what we refuse to estimate.
- [Glossary](https://reddenda.com/glossary): Plain definitions of the category vocabulary (RateScore, local peer median, P90 target, contracted rate, Transparency-in-Coverage, IDR, recoupment).
- [FAQ](https://reddenda.com/faq): Straight answers about the data, the RateScore, and pricing.

## For whom (6 provider types)
- [Private practices](https://reddenda.com/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.
  - [Primary care rates, national](https://reddenda.com/private-practice/primary-care): National percentiles for CPT 99213, 99214, 99203, and 99395. These are the codes a primary care practice bills; the percentiles themselves are all-specialty national figures, not a primary care peer pool.
  - [Internal medicine rates, national](https://reddenda.com/private-practice/internal-medicine): National percentiles for CPT 99213, 99214, 99204, and 99215. This page is the landing route for internal medicine subspecialties including nephrology and infectious disease.
  - [Pediatrics rates, national](https://reddenda.com/private-practice/pediatrics): National percentiles for CPT 99392, 99213, 99214, and 99203, covering the well child visit alongside the standard office visit codes.
  - [Behavioral health rates, national](https://reddenda.com/private-practice/behavioral-health): National percentiles for CPT 90837, 90834, 90791, and 99214, the therapy and psychiatric evaluation codes. The page links the US Commercial Reimbursement Report at https://reddenda.com/reimbursement-report, where behavioral health ranks worst paid against Medicare, and quotes no figure of its own for that finding.
  - [Physical therapy rates, national](https://reddenda.com/private-practice/physical-therapy): National percentiles for CPT 97110, 97140, 97530, and 99213. This is the landing route for physical therapy, occupational therapy, speech language pathology, and rehab practices.
  - [Orthopedics rates, national](https://reddenda.com/private-practice/orthopedics): National percentiles for CPT 99213, 20610, 29881, and 27447, spanning the office visit, the large joint injection, and the two highest volume knee procedures. This page is the landing route for podiatry, sports medicine, and spine.
  - [Cardiology rates, national](https://reddenda.com/private-practice/cardiology): National percentiles for CPT 93000, 93306, 93970, and 99214. This page also renders one live example row fetched at page load from a single public provider record, showing that record's RateScore and its modeled annual range, labeled as an example and never presented as a typical result.
  - [Gastroenterology rates, national](https://reddenda.com/private-practice/gastroenterology): National percentiles for CPT 45378, 45380, 43239, and 99214, covering diagnostic colonoscopy, colonoscopy with biopsy, and upper endoscopy with biopsy.
  - [OB/GYN rates, national](https://reddenda.com/private-practice/obgyn): National percentiles for CPT 99213, 99214, 99395, and 99204, covering established, new patient, and adult preventive visits.
  - [Dermatology rates, national](https://reddenda.com/private-practice/dermatology): National percentiles for CPT 99213, 17110, 11300, and 99203, covering wart destruction and shave removal alongside the office visit codes.
  - [Pain medicine rates, national](https://reddenda.com/private-practice/pain-medicine): National percentiles for CPT 64483, 64493, 62321, and 20610, covering lumbar epidural, facet joint, interlaminar epidural, and large joint injections.
  - [Emergency medicine rates, national](https://reddenda.com/private-practice/emergency-medicine): National percentiles for CPT 99284, 99285, 99283, and 99291. The page links the federal No Surprises Act dispute record at https://reddenda.com/litigation for out of network payment disputes, and quotes no win rate of its own.
- [Billing and RCM firms](https://reddenda.com/billing-companies): Score every client NPI in your book against the local peer median, 300 to 850, on one anonymized book yield board. No PHI required. Own entity: Pro $699/mo, up to 5 NPIs, one legal entity. Client books are scoped on a 30 minute book review call; multi-NPI work is never priced inline. Modeled dollars, not guaranteed.
- [DME suppliers](https://reddenda.com/dme): Same supply. Same code. Different checks. Since 2022 insurers publish what they pay for supply codes; the page renders live state peer percentiles (25th, median, 75th) on real purchase-basis HCPCS codes from /api/rate-benchmark, commercial market. Check your codes at app.reddenda.com/d/dme/dmepos. Multi-location work scoped on a call. Modeled, not guaranteed.
- [Specialty groups and MSOs](https://reddenda.com/group): Every provider. One rate map. Each NPI in the group scored against its local peer median, 300 to 850, rolled into one board-ready register (identities withheld; one live example renders from /api/ratescore-public). Multi-NPI work is never priced inline; it is scoped to the roster on a board call. Modeled, not guaranteed.
- [Behavioral health](https://reddenda.com/behavioral-health): What payers pay for therapy and psych codes near you, code by code, so you can document a parity gap. No PHI.
- [Channel partners and white-label](https://reddenda.com/partners): Resell or white-label the platform to your own book, with the rate engine under your brand.

## Partner program (published wholesale, five doors)
- [Partner with Reddenda](https://reddenda.com/partners): Consultancies, billing companies, and MSOs resell RateScore as their own. Published wholesale pricing on the page, flat fees, never a percentage of claims, in any state. No PHI, no integration project. Apply on the page or book a discovery call (https://calendly.com/reddenda/discovery).
- Five doors: Referral (20 percent of the practice's subscription for 12 months plus a $600 conversion bounty per converted practice, paid after hold windows; no activation, no monthly). Firm license (internal use powering your own advisory; ladder minus 15 percent). Reseller co-brand (the most common door: founding activation $2,500 with a $5,000 list rate, platform $499/mo under 25 practices or $999/mo at 25 plus, and a flat per-practice wholesale on a bracketed ladder). White-label (your brand only; from $1,499/mo, plus 25 percent on the ladder, 50-practice minimum; the RateScore attribution line is non-removable). Data/API (aggregate index licensing from $12,500; per-NPI scores are never licensed).
- The reseller ladder (percent of published list, bracketed like tax brackets, never a cliff): 40 percent at practices 1 to 24, 35 percent at 25 to 49, 29 percent at 50 to 99, 24 percent at 100 to 249, 20 percent at 250 plus. At the 2-NPI modal practice ($598/mo list) that is $239.20 down to $119.60 per practice per month. Partners resell within 80 to 100 percent of published list and keep the spread. Worked example at 50 practices billing at 80 percent of list: bill about $23,900/mo, pay about $12,100/mo, keep about $11,800/mo, a 49 percent blended margin. Modeled, not guaranteed.
- Honesty canon for partner claims: partner fees are flat dollars tied to practices served, never a percentage of claims, collections, or recovered amounts. Reimbursement opportunity figures are documented from public rates and modeled, never guaranteed. No PHI is required anywhere. Client provisioning is NPPES-verified.

## Pricing
- [Pricing](https://reddenda.com/pricing): Looking is free. Free RateScore $0 (no card, no PHI, no account). Reddenda Core $399/mo (one practice, one NPI). Reddenda Pro $699/mo (up to 5 NPIs under one legal entity). Enterprise, multi-NPI, MSO, and white-label are scoped on a call, always a flat fee, never a cut of collections.
- One-time deliverables (buy a single signable artifact, no subscription): Leverage Memo $299, IDR Evidence Exhibit $149, Practice Audit $697 (founding), Counteroffer Memo $1,900, Recoupment Defense File $1,200, Renewal Season Pack $4,900.

## Key terms
- [Glossary of rate intelligence terms](https://reddenda.com/glossary): Every term defined once, in plain language: NPI, CPT, HCPCS, payer, contracted rate, Transparency-in-Coverage, local peer median, P90 target, RateScore, MSO, RCM, DME, IDR, recoupment, renewal window, Leverage Memo, PHI, white-label, roll-up, AI Intelligence Brief, fee schedule, Medicare Fee Schedule, NPI Registry, BAA, documented reimbursement opportunity.

## Methodology
- [How the index is built](https://reddenda.com/methodology): The federal Transparency-in-Coverage rule (in force since 2022) requires insurers to publish the rates they negotiate. We index those public files, join them to the NPI Registry, benchmark against the CMS Medicare Fee Schedule, and gate every cell on real sample counts. Fewer than 8 local peers means no score is shown. Zero fabricated data.

## Free RateScore
- [Run a free RateScore](https://reddenda.com/rate-score): Look up any NPI in America. Your contracted rates vs nearby peers, 300 to 850, per payer and per CPT. About 15 seconds. No card, no PHI, no account.
- [Payer rate directory](https://reddenda.com/payer-rates): Browse published contracted rates by payer and code.
- [Programmatic layer](https://reddenda.com/sitemap-index.xml): Per-NPI RateScore pages at reddenda.com/npi/{npi}, per-code national rate-distribution pages at reddenda.com/cpt/{code} (what payers pay for a CPT nationally, observed across payer filings, never a local peer median), and per-code local benchmark pages at reddenda.com/rates/{cpt}/{payer}/{metro}, all generated from real counts with honest-empty gating.

## Data report (quotable, aggregate, updated live)
- [US Commercial Reimbursement Report](https://reddenda.com/reimbursement-report): What commercial insurers actually pay versus Medicare, from federal Transparency-in-Coverage filings. Key finding: across hundreds of millions of published commercial rate observations for the most common procedures, the median commercial rate is about 1.0x Medicare, and roughly 46% of these common procedures pay a commercial median BELOW Medicare, including the most common office visits (CPT 99213, 99214, 99215). For the same code, the 90th-percentile commercial rate is typically about 3x the 25th-percentile rate. Aggregate national distributions across payers, never a per-provider rate; no PHI; modeled, not guaranteed. Live figures update with the data.

## No Surprises Act IDR outcomes (quotable, aggregate, federal CMS data)
- [No Surprises Act IDR outcomes](https://reddenda.com/idr): Who wins federal out-of-network payment arbitration, and by how much. Key finding: providers prevail in about 86% of resolved IDR disputes, and the prevailing award is a median of about 391% of the qualifying payment amount (QPA), across roughly 2.25 million disputes, with breakdowns by payer, specialty, and state (for example, radiology providers win about 93%; against some payers the median award exceeds 470% of QPA). From the federal CMS IDR public-use files. Aggregate only, no PHI; informational, not legal advice; past outcomes do not guarantee future results.

## Live coverage (point-in-time, distinct from the marketed scope above)
- The marketed scope (314M+ records, 500+ payers, 50 states, 9.2M+ NPIs) is the universe Reddenda indexes toward, not a live-queryable count. The live-indexed subset is published at https://reddenda.com/api/public/stats and, as of 2026-07-23, covers 5.85M contracted-rate rows across 19 payers, 51 states, 5,219 CPTs, and 276,700 NPIs with data. Example from the same source and date: CPT 99213 (established-patient office visit, all specialties) shows a p50 of $92.75 and a p90 of $169.70 across 2.73M observed rate samples. These figures refresh with the data; always defer to /api/public/stats for current values. Documented from public rates, modeled and not guaranteed.

## Policies
- Documented reimbursement opportunity, modeled and not guaranteed. Actual outcome depends on payer response, contract terms, and negotiation. Not a guarantee of recovery.
- No PHI required. Reddenda works only from public rate files and never needs or sees patient data. Not HIPAA certified language, no BAA implied, because none is needed.
- RateScore is always vs the local peer median, never a national median or average.
- Multi-NPI, MSO, and white-label are always scoped on a call, never an inline price.
- [Federal IDR payment disputes](https://reddenda.com/litigation): Out of network payment disputes under the federal No Surprises Act have a public record, and providers win most of them (the live win rate, dispute count, and as-of date render on the page from the CMS IDR public use files). Deliverables: IDR Evidence Exhibit $149, Recoupment Defense File $1,200; a performance lane exists where state law allows, closed on a call with server-side NPPES state verification. Reddenda is not a law firm; data exhibits, not legal advice; past outcomes do not guarantee future results.
- [Renewal season](https://reddenda.com/renewal-season): Payer fee schedules turn over on published file dates, in waves. Live wave shares and tracked-NPI counts from /api/public/stats (as_of-stamped, scoped to our tracked index). Check a renewal window free by NPI. Deliverables: Leverage Memo $299, Counteroffer Memo $1,900, Renewal Season Pack $4,900 (closed on a call). Every dollar modeled, not guaranteed. Payer file dates, not confirmed contract anniversaries.