409
F
PayerScore · Third-party administrator · New Jersey
Total Plan Concepts, New Jersey
300 to 850 · lower is worse for providers · 575 = median payer conduct
97%
providers win their IDR disputes
316%
median award vs the payer's QPA
61%
payer default / non-response rate
40
resolved federal IDR disputes
In New Jersey, Total Plan Concepts treats providers among the worst. Providers win 97% of resolved federal IDR disputes against it here, at a median award of 316% of the payer's own qualifying payment amount.
← Total Plan Concepts nationally (300 F)
See the full breakdown
The interactive Payer Explorer shows the code-by-code detail, the dispute history, and where your own book sits against Total Plan Concepts. 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 Total Plan Concepts.
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.