Practice Audit · Sample ReportBehavioral health edition · live benchmark math insidePortfolio edition for billing companies and MSOs →
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Practice Audit · Rate Intelligence Report
Sample Report
The complete picture of
what your payers should be paying.

Every contracted rate, benchmarked code by code against federal Transparency-in-Coverage filings, Medicare locality math, and peer percentiles — then turned into the letter you send.

PracticeSample Behavioral Health Group
SpecialtyBehavioral Health · TMS · IOP
LocalityTexas (ZIP 75001)
Generated
01 · Executive summary

Where the money is

Illustrative figures from a representative behavioral health panel, clearly marked as sample. Your report computes every number from your NPI's indexed payer rates and real volume.

Documented opportunity$148,200/yr · sample panel
Codes benchmarked14across 6 service lines
Payers compared9federal TiC filings cited
Documented reimbursement opportunity vs published benchmarks — an estimate, not a guaranteed outcome. Every line in the live report carries its source citation.
02 · Medicare locality benchmark — live, real data

This table is computed in real time

Not a mockup: these rows are calculated live from the CMS Physician Fee Schedule with GPCI locality adjustment at 110% — the benchmark behavioral health billers already trust, automated. Codes the fee schedule does not price honestly say so, rather than showing an invented number.

CodeServiceMedicare baseBenchmark ×1.10Status
Computing live from CMS PFS + GPCI…
03 · Rate gap analysis

Your top code, fully open — the rest unlock with the audit

In the live report, the code with the highest annual uplift is always fully unlocked: every payer line, every percentile, the expanded view. Sample values below.

CodePayerYour ratePeer P75Gap / unitUnlock
90837Payer A sample$96.40$132.00+$35.60Unlocked
90837Payer B sample$101.25$128.50+$27.25Unlocked
90868UnitedHealthcare West$188.00$221.40+$33.40Unlock data →
S9480Aetna Behavioral$612.00$745.00+$133.00Unlock data →
H0015BCBS of Texas$540.00$655.00+$115.00Unlock data →
04 · The payer-ready letter

It ends in a letter, not a spreadsheet

Every audit closes with the Leverage Memo: the renegotiation letter citing the payer's own federally filed rates, ready to sign and send.

Dear Provider Relations,

Per your organization's federal Transparency-in-Coverage filing (plan-id-masked-000, effective Jan 2026), your published in-network rate for CPT 90837 in our locality is $000.00. Our current contracted rate of $00.00 sits 00% below your own published benchmark, and below the Medicare ×1.10 locality reference of $000.00. We are requesting an adjustment to $000.00, supported by the attached exhibits…

— Full letter, citations, and exhibit pack included in every live audit.
Sample · 1 of 1 Sources & honesty. Sample rows are clearly marked and illustrative. The live Practice Audit computes every figure from your NPI: federal Transparency-in-Coverage filings (payer-published negotiated rates), the CMS Physician Fee Schedule with GPCI locality adjustment, and peer percentiles from the indexed rate universe. Flat fees only. Documented reimbursement opportunity — an estimate, never a guaranteed outcome. Not legal advice. © 2026 Reddenda · reimburseos.com

See this report with your numbers in it.

The live audit runs on your NPI: your payers, your contracted rates, your locality math, and the letter ready to send.

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