PayerScore · Health insurer · national

Providence Health Plan

Name: PayerScore source data: public federal IDR dispute records
Creator: Reddenda
License: https://reddenda.com/payer/methodology

300 to 850 · lower is worse for providers · 575 = median payer conduct

61%

providers win their IDR disputes

646%

median award vs the payer's QPA

19%

payer default / non-response rate

835

resolved federal IDR disputes

Providence Health Plan loses its IDR disputes and sees awards land well above its own QPA offers. Providers win 61% of resolved federal IDR disputes against it nationally, at a median award of 646% 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.

Providence Health Plan by state

OR · 549 D

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The interactive Payer Explorer shows the code-by-code detail, the dispute history, and where your own book sits against Providence 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.