Benchmark by payer and procedure
Inspect observed negotiated-rate distributions by CDT code, payer, geography, and provider context where data supports it.
Make payer contracting a portfolio strategy. Compare available local negotiated-rate evidence against your own fee schedules, locate material gaps, and enter negotiation discussions with a defensible plan.
A clean claim can still settle at a rate that trails comparable local contracts. Across a multi-location group, inconsistent schedules, acquired practices, and overlapping network relationships make those gaps hard to see.
Connect fragmented payer and location data to the decisions that can improve reimbursement performance.
Inspect observed negotiated-rate distributions by CDT code, payer, geography, and provider context where data supports it.
Compare organization-supplied fee schedules and volumes with local benchmarks to identify high-priority contracting reviews.
Bring rate comparisons, network context, and contract terms together before a human-approved payer conversation.
PayorMap helps structure the research and evidence. Every conclusion must match the coverage and quality of the underlying observations.
Which of our locations have the largest supported gaps on crown, implant, and hygiene codes?
Are similarly situated practices on different payer fee schedules?
Which contract renewals should we prioritize given opportunity, evidence quality, and timing?
Define your locations, TINs, covered codes, payers, and contracts; avoid patient-level data.
Check payer product, geography, source date, rate definition, provider mapping, and sample sizes.
Combine validated rates with organization-specific procedure volumes and documented assumptions.
Prioritize outreach, review negotiation materials, and verify any eventual collections improvements.
A possible assessment structure—not a pre-generated report or a guarantee every data field exists in every market.
Discuss your assessmentOnly after your organization provides reliable schedules or equivalent current contract evidence. Market benchmarks are not automatically your rates.
No. It indicates a potential contract opportunity, not a claim payment error. Comparability and contract terms still require validation.
Tell us what you are evaluating, and we can review relevant payer, location and code coverage together.