Product methodology
Denial Reason Atlas
Source contract, normalization path, entity-graph join, refresh posture, and publication limits for this Branmoor product.
Status
Pending. This product is pending. The methodology page is published first so the source contract and join path are visible before Branmoor represents the product as live.
Distribution Scope
Nationwide where disclosures exist; TN/TennCare focus; Davidson County Atlas
Product Question
Surfaces denial patterns by payer, code, provider, and geography.
Primary Sources
- State-mandated denial-rate disclosures — Aggregate denial rates by payer (where required: e.g., California, New York, Colorado, Washington)
- CMS Transparency in Coverage allowed-amount files — Out-of-network allowed amount records, payer-level coverage signal
- Federal No Surprises Act IDR Public Use Files — Outcome of independent dispute resolution by payer and service
- State insurance department complaint data — Consumer-filed appeal data, sometimes with outcome
- CMS Marketplace appeals data — ACA plan appeal outcomes by issuer
Entity-Graph Join
`payer_id`, `procedure_code`, `npi`, `ccn`, state regulator entity, county/market.
Publication Rule
Branmoor does not treat raw public records as the product. A surface is publishable only when the source record is dated, normalized, source-linked, and joined to the relevant Branmoor entity identifiers with enough confidence to state the limits of the result.
Current Methodology Note
Coverage is uneven by state — states with disclosure mandates have richer underlying data. Every cell carries a confidence band reflecting the underlying sample. Source documents are linked.
Limits
Coverage follows the underlying source. Missing state portals, gated APIs, PDF-only filings, suppressed fields, lagged agency refreshes, and entity-name ambiguity can all limit product completeness. Pending products are not marketed as live until those limits are documented on the product surface.