315
F
PayerScore · Health insurer · New Jersey
EmblemHealth, New Jersey
300 to 850 · lower is worse for providers · 575 = median payer conduct
95%
providers win their IDR disputes
560%
median award vs the payer's QPA
65%
payer default / non-response rate
1,316
resolved federal IDR disputes
In New Jersey, EmblemHealth treats providers among the worst. Providers win 95% of resolved federal IDR disputes against it here, at a median award of 560% of the payer's own qualifying payment amount.
← EmblemHealth nationally (300 F)
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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.
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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.