392
F
PayerScore · Health insurer · national
The Health Plan
300 to 850 · lower is worse for providers · 575 = median payer conduct
90%
providers win their IDR disputes
412%
median award vs the payer's QPA
56%
payer default / non-response rate
192
resolved federal IDR disputes
The Health Plan treats providers among the worst in the country. Providers win 90% of resolved federal IDR disputes against it nationally, at a median award of 412% 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.
The Health Plan 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 The 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.