449
F
PayerScore · Health insurer · national
QualChoice
300 to 850 · lower is worse for providers · 575 = median payer conduct
91%
providers win their IDR disputes
851%
median award vs the payer's QPA
11%
payer default / non-response rate
290
resolved federal IDR disputes
QualChoice treats providers among the worst in the country. Providers win 91% of resolved federal IDR disputes against it nationally, at a median award of 851% 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.
QualChoice 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 QualChoice. 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 QualChoice.
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.