The HMOs’ claims and benefits administration department, on the other hand, is responsible for ensuring that all providers are paid for their services and that health care benefits that members are entitled to are honored by the organization (Kongstvedt, 2009; Anderson & Gray, 2013).
Finance and budget
In terms of finance and budget administration, the MSO manages inventory; prepare budgets and financial statements; manage overhead and revenue; manage accounting and auditing; payroll and benefits; inventory management for their providers. Likewise,the HMOs' finance department manages and trace their organizations' money throughout their operational systems and the budgeting department is responsible for their medical expense and operating expense budget. However, the health insurance companies are not involved in either the operational finances or budgeting of their contracted physicians (“Welcome to HealthSmart MSO,” 2015). Marketing and Sales
The MSOs is responsible for business development and marketing, sales for their providers while the HMO’s are responsible for the development of their organizational marketing strategies and sales of their own products.
Credentialing and relations In addition to assisting providers with accreditation; negotiating, monitoring, managing…show more content… Conversely,the managed care, HMOs and PPOs’ fundamentals principles are rooted in their ability to reduce the costs of hospitals and physicians by providing a set of incentives and disincentives for physicians to limit their use of unnecessary medical