This one-day Masterclass with Maria Todd covers tactics and strategies to avoid and eliminate unauthorized discounting by non-contracted payers and rental networks. Learn how to Learn what to look for and how to eliminate these financial risks from your contract portfolios. Take home a 16-point checklist of contract terms and conditions to avoid oversights in boilerplate agreements and learn how to push back if the plan won’t remove the objectionable contract terms.

1. Speaker: Maria K Todd, MHA PhD
Event Type: Interactive 1-day Workshop
For the past 15+ years, hospitals, physicians and other healthcare providers have suffered financially at the hand of
illegitimate discounters operating Silent PPO/rental networks without their express consent or knowledge. If you work in
any department associated with healthcare revenue management and the term is unfamiliar to you, take this opportunity to
learn what it is, how it affects your reimbursement, what to do to eliminate unauthorized discounting from your contracts
and reimbursement agreements.
Maria Todd has been training hospitals, physicians and other healthcare providers about the perils and pitfalls of Silent
PPO/Non-contracted rental network discounts since 2006. When a healthcare provider contracts to join a health plan
network, it agrees to accept a discounted rate in return for the plan steering patients to their organization practice through
a listing in the health plan’s directory. With Silent PPO’s you don’t get the trade off. You simply get paid less than you billed
by a non-contracted network you may have never heard of before and owe no duty to accept their discounted payment.
Over the past 15+ years, your discounted rate has been highjacked through a deceptive market practice called a “silent
PPO” or “rental network.” A silent PPO/rental network is neither insurance nor a health care payment plan offered by a
health plan to its clients. Silent PPO/rental networks are not universally regulated and create a huge obstacle to heath care
transparency. they take many forms
Silent PPOs and rental networks generally assume no financial risk. They locate the lowest rates a provider has agreed to
with any insurer, then pay a fee to borrow that discounted rate from another payer without the provider’s knowledge or
permission. Only a few states have laws in place to prohibit these arrangements, but you can still unwittingly give up your
protections under those laws with one tiny one-word oversight or mis-assumption in your managed care agreements.
What’s worse is that your patients also may suffer financially when the discount applied to their medical treatment is based
inappropriately on the lowest contracted rate of a silent PPO/rental network. The patient may have to pay more toward the
unpaid balance and incur higher cost sharing and out of network stacked deductibles.
In most cases, Silent PPO/rental networks provide no benefit to providers or their patients. Ultimately they may become
wary of granting discounts under their existing contracts or are forced to increase their existing contracted rates to offset
losses from these unethical manipulations. They may also miss the one word change necessary to protect their interests
under contracted reimbursement agreements.
• Learn what to look for and how to eliminate these financial risks from your contract portfolios.
• Take home a 16-point checklist of contract terms and conditions to avoid oversights in boilerplate agreements.
• Learn how to push back if the plan won’t remove the objectionable contract terms.
• Understand what it takes to enforce the terms of your discounted fee-for-service agreements.
• Learn how to force the seller of your discount to apply pressure on their client to pay you according to your contract.
• Learn what to ask and how to respond when you see multiple logos on subscriber ID cards.
• Take home sample language that clarifies your position on nefarious conduct and unauthorized discounts.
Dr Maria Todd will share and compare her perspective and experience contracting for more than 4000 healthcare providers
across the USA and conducting Silent PPO recovery initiatives to get paid on unauthorized discounts. She will present real
life case studies and provide practical, pragmatic insights. Numerous useful course supplemental materials are provided at
no additional charge.