616
C
PayerScore · Health insurer · Florida
Capital Health Plan, Florida
300 to 850 · lower is worse for providers · 575 = median payer conduct
67%
providers win their IDR disputes
285%
median award vs the payer's QPA
28%
payer default / non-response rate
902
resolved federal IDR disputes
In Florida, Capital Health Plan sits near the middle of payer conduct. Providers win 67% of resolved federal IDR disputes against it here, at a median award of 285% of the payer's own qualifying payment amount.
← Capital Health Plan nationally (616 C)
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The interactive Payer Explorer shows the code-by-code detail, the dispute history, and where your own book sits against Capital Health Plan. 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.