300
F
PayerScore · Health insurer · national
EmblemHealth
300 to 850 · lower is worse for providers · 575 = median payer conduct
95%
providers win their IDR disputes
745%
median award vs the payer's QPA
63%
payer default / non-response rate
1,887
resolved federal IDR disputes
EmblemHealth treats providers among the worst in the country. Providers win 95% of resolved federal IDR disputes against it nationally, at a median award of 745% of the payer's own qualifying payment amount. That is a documented signal of how far its offers sit below the amount the independent IDR arbiter selected.
EmblemHealth by state
See the full breakdown
The interactive Payer Explorer shows the code-by-code detail, the dispute history, and where your own book sits against EmblemHealth. It is a documented reimbursement opportunity, modeled not guaranteed.
Score your own rates free Open the Payer ExplorerShare this grade
One tap puts the number in front of every provider who deals with EmblemHealth.
See how your own payers grade
Get the PayerScore for the plans on your own contracts, and a quarterly note when any grade moves in the federal record.
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.