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VoIP<->PSTN

Hi Group.

I am a first-time poster and joined the group a couple of weeks ago,
primarily because I am keen to gain a good 'executive' understanding of
the technologies of the modern telecoms market.

Can anyone please explain how VoIP interracts with the fixed-line
telephone network?  I mean, do VoIP providers need a presence at an
exchange?  How does the call get from the PSTN to the internet and vice
versa?  If I have a geographic number with a VoIP provider do people get
local rate calls to me from the same area code?  If so, do I have to
pay?

Thanks,
Chris