Silent PPOs are a growing problem, siphoning billions each year from the health care system while going completely unregulated in many states.
In a silent PPO arrangement, an insurer sells or rents its network to a discounter that takes advantage of discounts the insurer negotiated with the physician—often unbeknownst to the physician.
The discounter finds and gives their clients the lowest discounted rate while profiting off the margins. They claim to keep health care costs down but savings line their pockets instead of being passed along to patients or employers. Physicians lose money in these arrangements and are faced with additional administrative costs.
Fee schedules are often sold or rented without the physician’s authorization. Discounts are applied at a lower rate than the contracted rate. Discounts are even given after the physician has cancelled the contract.
Get more information about how this happens and what you can do to stop it. Member login is required.