In part one of this two-part look at contracts, we review which clauses in your payer contracts should raise red flags. In part two, we'll examine how to respond if payers fail to keep up their end of the contract. Although it is potentially one of the most difficult responsibilities of your job, understanding and negotiating payer contracts is integral to the ultimate success of your practice. Think you need a legal degree to be contract savvy? The good news is that in most instances, that's not the case, said Sherri C. Staat, CMPE, administrator for Orthopaedic Associates Medical Clinic in Visalia, CA, who offered her in-the-trenches advice about contracts during a two-part seminar at the 2006 MGMA Financial Management Society-Managed Care Assembly in San Diego.

Undetected silent PPOs may be cashing in on your patients One of the most financially dangerous yet least talked about problems facing providers today are silent preferred provider organizations (PPO). A basic form of managed care, silent PPOs offer patients your practice's reduced rates without your physicians knowing and without exchanging those rates for the normal benefits of PPO participation. Of course, not all PPOs are bad. A legitimate PPO consists of a network of providers and hospitals that agree to accept a discounted fee schedule in return for being a preferred provider. When a provider joins a PPO, that provider's organization enters into an agreement with the payer.

Editor's note: This is the second in our two-part series on physician philanthropy. In our June issue, we examined how you can combine investing and charity by adding a social investment plan to your portfolio. Medical school students say that one of the top reasons they choose medicine as a career is the desire to make a difference in people's lives, according to an annual survey conducted by the American Association of Medical Colleges. This philanthropic aspiration compels many physicians later in their careers to volunteer their time and medical skills to charitable causes, both in the United States and abroad.