PPO Network & Other Contract Issues

Payers have long engaged in abusive practices with PPO networks, resulting in significant discounts applied to which they were not legitimately entitled.

While silent PPOs involve the impermissible use of PPO discounts to which payers are not a party, other PPO network issues involve payers simply ignoring terms of legitimate PPO network contracts. Instead of paying at agreed upon rates or terms, payers routinely apply other discounts or reductions, layer discounts upon discounts or state mandated fee schedules (as in Workers Comp), deny payable claims, or make untimely payments in violation of contracts.

  • TGF works with these imprudent payers and applicable PPO networks to require adherence to the terms of legitimate PPO agreements