Source evidence
Payor-published machine-readable files reporting actual negotiated in-network rates, plus other permitted reference sources, with source and date context.
OUR METHODOLOGY
Make the evidence do the talking.
How PayorMap turns published negotiated-rate evidence, provider context and contracts into decisions—without confusing reported rates with claim payments or modeled upside.
The process
From fragmented files to decision-ready intelligence.
Rates are useful only when their sources, units, dates, markets, and provider relationships are understood. PayorMap is designed to make that context available alongside the conclusions.
Compare like with like
Standardize CDT codes, geography, payor identifiers, networks, and provider associations where reliable matching is possible.
Understand the distribution
Compare appropriately scoped observations and identify where a known contracted reimbursement amount sits within the relevant market distribution.
Estimate the gap
Apply contract and optional utilization information to model potential value. An estimate is not a guaranteed increase or realized revenue.
Inspect the evidence
Expose underlying payor, market, date, and code context; disclose coverage limitations and unresolved network or provider matching.
Measure actual results
For implemented increases, compare actual collections before and after the effective date while accounting for mix and other material changes.
Interpreting the data
What these numbers do—and do not—mean.
PayorMap reports observation volume, not necessarily unique participating dentists, unique contracts, or distinct reimbursable claims. Availability varies by payor, geography, product, CDT code, publication date, and source quality.
Important distinctions
Published negotiated rate: an in-network rate amount disclosed by a payor in a source file—not a PayorMap estimate. It may not match an individual provider's contract, a claim's allowed amount or the amount ultimately paid; source accuracy and network/product context still matter.
Market percentile: a distribution benchmark from observations meeting the selected filters. It is not automatically a prevailing or attainable contracted price.
Modeled opportunity: a scenario based on explicit reimbursement gaps and assumptions about use or volume.
Verified improvement: a separately measured change in actual reimbursements or collections, where supporting evidence is available.
Customer-provided information
More context creates better answers.
When appropriate, customers can provide current fee schedules, contract terms, location mappings, and utilization. Those inputs improve comparison quality and may affect opportunity estimates.
Discuss an assessmentLimitations and safeguards
Data refreshes can occur at different times by source. A current platform refresh does not mean every payor publishes new data monthly.
Mapping can be uncertain when payors, leased PPO networks, or provider identifiers are ambiguous. Unsupported or missing comparisons should not be treated as confirmed gaps.
The platform supports analysis and contracting preparation; it does not guarantee payor participation, contract renegotiation, payment, or financial outcomes.