310
F
PayerScore · Blue Cross Blue Shield plan · Pennsylvania
Keystone Health Plan East, Pennsylvania
300 to 850 · lower is worse for providers · 575 = median payer conduct
93%
providers win their IDR disputes
8,919%
median award vs the payer's QPA
61%
payer default / non-response rate
38
resolved federal IDR disputes
In Pennsylvania, Keystone Health Plan East treats providers among the worst. Providers win 93% of resolved federal IDR disputes against it here, at a median award of 8,919% of the payer's own qualifying payment amount.
← Keystone Health Plan East nationally (311 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 Keystone Health Plan East. 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.