582
D
PayerScore · Health insurer · Texas
Aetna, Texas
300 to 850 · lower is worse for providers · 575 = median payer conduct
93%
providers win their IDR disputes
533%
median award vs the payer's QPA
29%
payer default / non-response rate
204,374
resolved federal IDR disputes
Contracted-rate position: across the codes we can compare, this payer pays about 100% of the local peer median (documented public rate data). Lower means it pays providers less than the local market.
In Texas, Aetna loses its IDR disputes and sees awards land well above its own QPA offers. Providers win 93% of resolved federal IDR disputes against it here, at a median award of 533% of the payer's own qualifying payment amount.
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The interactive Payer Explorer shows the code-by-code detail, the dispute history, and where your own book sits against Aetna. It is a documented reimbursement opportunity, modeled not guaranteed.
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About this grade. PayerScore is a modeled index and an opinion derived from disclosed public data, not a statement of fact about the payer's conduct. It is computed by deterministic method (v1.0.0) from public federal IDR dispute records (CMS Public Use File) and documented public rate positions vs the local peer median. These are federal independent-dispute-resolution records, not court judgments or litigation. Figures are modeled, not guaranteed. See the methodology. A payer may request a correction at corrections@reddenda.com.