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Related Concept Videos

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Persuasion Strategies

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Updated: Apr 7, 2026

Measuring Delay Discounting in Humans Using an Adjusting Amount Task
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Stopping Unauthorized Discounts.

Dennis Hursh

    The Journal of Medical Practice Management : MPM
    |July 18, 2015
    PubMed
    Summary

    Preferred provider organizations (PPOs) offer good reimbursement, but healthcare practices must guard against "silent PPO" schemes. Vigilance is key to protecting practice revenue and patient care.

    Area of Science:

    • Healthcare Management
    • Health Insurance Economics

    Background:

    • Preferred Provider Organizations (PPOs) are a common health insurance model.
    • PPOs can offer significant reimbursement rates for healthcare providers.
    • Practices face risks associated with PPO contracts.

    Purpose of the Study:

    • To highlight the financial risks associated with Preferred Provider Organizations (PPOs).
    • To define and explain the concept of a "silent PPO."
    • To advise healthcare practices on safeguarding reimbursements.

    Main Methods:

    • Analysis of PPO contract structures.
    • Review of common "silent PPO" tactics.
    • Case study examination of reimbursement discrepancies.

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    Main Results:

    • "Silent PPOs" can lead to reduced reimbursements for providers.
    • Lack of transparency in PPO networks facilitates "silent PPO" schemes.
    • Proactive contract review is essential for financial health.

    Conclusions:

    • Healthcare practices must implement strategies to prevent "silent PPO" abuses.
    • Understanding PPO contract nuances is critical for financial sustainability.
    • Ensuring fair reimbursement requires diligent monitoring of PPO arrangements.