Benefits of the Silent PPO Identification & Recovery Service:

Recover revenue for your hospital on a risk-free, contingent basis from payers who have accessed discounts to which they are not entitled, while not disrupting your Business Office's day-to-day operations.
Provide business intelligence that identifies payers who take advantage of the provisions in
current contracts.
Review commercial managed care contracts, identify loopholes and recommend model contract language to incorporate into agreements to deter "Silent PPO" abuses in the future.

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The American Hospitals Association estimates that hospitals lose 1-3% of net revenue each year from inappropriate practices of PPOs. To combat this, MD-X's "Silent PPO" Service provides hospitals with a risk-free, contingency based solution that recovers incremental revenue.

MD-X recovers lost revenue for hospitals and eliminates "Silent PPO" activity and related underpayments. MD-X screens zero-balance accounts to identify and recover improper managed care network/payer discounts. MD-X also assists hospitals in initiating contract negotiations and closing "Silent PPO" loopholes in their managed care contracts. The end result - hospitals are empowered to monitor, identify and prevent future payment abuses from "Silent PPOs."

Our Silent PPO Services Include:

Auditing zero balance accounts for multiple years
Determining when payers are in violation of contractual terms
Recovering the inappropriate discount
Recommending language to close contractual loopholes


Protection Against Underpayment
PPO Contract Analysis & Negotiation


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