Silent PPO

A Silent PPO is an organization that sells a discounted rate for services from a physician, hospital or other health care provider without authorization to do so. The buyers of the discounted rate might be insurance companies, self insured employer health plans or another Silent PPO. The Silent PPO could have access to the discount legitimately - the physician negotiated with the entity to give the discount to X but the entity sold it to Y as well. The Silent PPO could also be a "middle man" and resell it. The problem is that when the physician negotiated the discount, they intended to give it only in exchange for referrals - where a patient is given some advance incentive to choose them. Silent PPOs typically do not make referrals, but provide access to the discount after the service was rendered.