When the payment review arrives, your documentation is already built.
DME lives under more payment review than almost any provider type. Every commercial contracted rate on your HCPCS set, benchmarked and source-cited from federal filings, ready before the letter lands.
Documented reimbursement opportunity, modeled and not guaranteed. No PHI.
Same machine. Same code. Four times the money.
What different payers' published files say they pay for the same CPAP code, median per payer file:
Live medians from the Reddenda index of federal Transparency-in-Coverage filings, by payer file, national scope. Where your contract sits in this spread is the question a payment review asks — and the question your documentation should already answer.
The payment review arrives on their schedule, not yours.
Reviews outpace records
Starting your documentation after the letter lands is the most expensive possible moment to start.
No benchmark on file
The law made every payer's prices public. Parsing 314M+ records into your benchmark takes infrastructure suppliers don't have. That is the part we built.
Responses without citations
A response built on internal spreadsheets reads like an opinion. A response built from federal filings, with a source citation on every number, reads like a record. Payers treat the two very differently.
Three steps to documentation that is already built.
We index your set
Your NPI resolves your HCPCS codes and commercial payers against the federal filings. No PHI, ever.
Every code, cited
Each contracted rate benchmarked against the payer-published market, a federal source citation on every number.
The dossier
One code, one payer, one documented record you can hand over — before the recoupment demand lands.
Watch the whole set for $399 a month. Stand up a defense file when it counts.
Reddenda Core watches one NPI daily — every payer, every HCPCS code, rate-change and recoupment alerts. When a recovery demand lands, the Recoupment Defense File ($1,200 one-time) assembles your documented position with receipts.
Every figure is a documented reimbursement opportunity, modeled from public federal rates against the payer-published market. Actual outcome depends on payer response, contract terms, and negotiation. Not a guarantee of recovery.