Alter current procedures to reduce silent PPO activity
Silent PPOs, as their name indicates, can be difficult to identify. To avoid falling prey to these sneaky imposters-and correct the situation if you do-you first must learn to identify silent PPOs.
Regular PPOs connect providers contractually with insurance companies that send providers patients, thus increasing patient volume. In exchange, providers offer payers discounts on their billed charges.
However, silent PPOs enjoy these discounted reimbursement rates without fulfilling any steerage obligations. A managed care organization sells or rents its PPO provider network to a third-party or broker, which then avoids paying higher out-of-network fees.
Most Viewed
Most Emailed
- Urologists 'Outraged' Over PSA Test Challenge
- Luxury Hospital Facilities Put Patient Experience First
- Mapping Out Revenue-Cycle Solutions
- Will Maryland's Rate Shift Send Tremors Around the Country?
- E-book Revolution Changes, Challenges Healthcare
- How Rivals Built an ACO
- New Facebook Page Gathers Stories of Medical Harm
- ICD-10 Coding Uncovers Higher Rate of Fatal Falls Among Seniors
- FL Hospital Vendors Sentenced in Bribery Scheme
- Health Insurance Exchanges Put Defined Benefits to the Test

