Question

SG&A stands for:

Sales, Goods and Allowance

Sales, Governance and Administration

Sales, Governance and Activities

Strategy, Governance and Administration

All MCOs have a Board of Directors.

True

False

In many MCOs, the CEO/Executive director is usually responsible for the overall operations of the plan and the Medical Director is responsible for the QM, utilization management and medical policy.

True

False

A state has the ability to establish stricter privacy and policy requirements than originally set by HIPPA.

True

False

Marketing and sales departments provide the same function in a MCO.

True

False

Answer 1

1. SG &A stands for:

a.Sales, goods, allowance- Sales , marketing and public relations denotes sales(S), G for governance includes board of directors and other organisational officers, A for administration including medical management and payer's other processes and operations.

b.Sales, governance and administration(Answer) SG &A is a financial term commonly applied to various ongoing managerial and operational functions and processes performed by payer organisation in managed health care. S- Sales and marketing and public relations. G- Governance includes board of directors and organisational officers and managers. A- Administration includes payer's processes and operations, including network and medical management.

c.Sales , governance and activities: This is not the expansion of SG& A

d.Strategy, governance and administration: S denotes sales and not strategy. So this option is wrong.

2. All MCOs have a Board of Directors.

Answer:Most of the managed care organisations have board of directors but not all organisations. So the statement  is false.

3.In many MCOs, the CEO/Executive director is usually responsible for the overall operations of the plan and the Medical Director is responsible for the QM, utilization management and medical policy.

Answer: Key management function of CEO /executive officer is the operational aspect of the plan in managed healthcare organisations. Medical director's function is taking care of provider relations,provider recruitment, quality management, utilization management, medical policy. The statement is true.

4. A state has the ability to establish stricter privacy and policy requirements than originally set by HIPPA

Answer: Health Insurance Portability and Accountability Act addresses the use and disclosure of protected patient health information.The state law may apply if it is more strict than HIPPA. The statement is true.

5. Marketing and sales departments provide the same function in a MCO.

Answer: Marketing, sales and public relations comes under sales department in a managed healthcare organisation .The statement is true.