Reddenda · PayerScore
481
F
PayerScore · Third-party administrator · national

HealthSmart

300 to 850 · lower is worse for providers · 575 = median payer conduct
85%
providers win their IDR disputes
240%
median award vs the payer's QPA
76%
payer default / non-response rate
96
resolved federal IDR disputes

HealthSmart treats providers among the worst in the country. Providers win 85% of resolved federal IDR disputes against it nationally, at a median award of 240% 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.

HealthSmart by state

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The interactive Payer Explorer shows the code-by-code detail, the dispute history, and where your own book sits against HealthSmart. It is a documented reimbursement opportunity, modeled not guaranteed.

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Get the PayerScore for the plans on your own contracts, and a quarterly note when any grade moves in the federal record.