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Member Engagement

For High Quality and Compliance, Focus on the Member

Everything about value-based healthcare focuses around the member, and so should your system. MedHOK looks at Member Engagement through the lens of the members’ complete experience, from point of sale to full-on care management. Successful engagement meets the member at all touchpoints throughout the care continuum and through their preferred method of engagement.

MedHOK provides full-function member engagement through proactive features, such as MP (MarketProminence) Sales and Marketing, MP Enrollment, MP Financial Reconciliation as well as the Unified Payer Platform’s Health Education and Outreach, and responsive functions including Member Portal, Customer Relations, Complaints Tracking, Grievance resolution, and world-class service enablement. Plus, MedHOK is always fully compliant with CMS requirements such as eligibility, marketing tracking and reporting, and timely processing.

What’s more, MedHOK’s platform records every interaction, including all current and archived cases, prior authorizations, interventions, appeals, grievances, complaints, over-the-counter medication, clinical surveys, notes, correspondence, and more, at the patient level for easy retrieval and audit.

With real-time access to member data, MedHOK’s Unified Payer Platform enables payers to more effectively enroll, educate and outreach to members, and be responsive to their needs. This unwavering commitment to member service yields high member satisfaction, making high quality and Star ratings achievable and sustainable.

COMPLETE 360° MEMBER VISIBILITY

Access members’ complete medical and pharmacy history, and all interactions with one click from anywhere in the MedHOK platform, so you can deliver quality care and service

FULL FUNCTION MEMBER ENGAGEMENT

Proactive and responsive member engagement — from enrollment and outreach to appeals and grievances — is critical for success with value-based healthcare

PROVEN FORMULA FOR ACHIEVING 5-STAR SUCCESS

MedHOK enables workflows that facilitate consistent and compliant member engagement, leading to better overall service, higher quality scores, and increased revenue

Member Engagement Components

MedHOK delivers proactive and responsive member engagement capabilities throughout the member engagement cycle, from fully compliant eligibility and enrollment through world-class customer support enabling organizations to boost quality scores and drive unparalleled customer satisfaction.

Learn more about the Member Engagement components in MedHOK’s Unified Payer Platform by clicking the titles below.

White Paper

Focus on the Member: The Premise for Value-Based Healthcare

Value-based healthcare requires a focus on the member, quite a shift from the provider-centric, transaction-focused models with which payers are familiar. This paper discusses how a focus on the member will result in better quality, care, and outcomes.

Fill out the form to the right to download the paper now.

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