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Unified Payer Platform

Essential to Success in Value-Based Healthcare

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    MedHOK takes all medical and pharmacy information, as well as data from multiple, disparate sources, and integrates it using a turn-key platform solution.


    Creates a 360 Degree View

    Data from enrollment, Pharmacy, Medical, Claims, and CMS are normalized, creating a 360-degree view of the member for system-wide access.


    Triggers Alerts and Interventions

    With real-time and historical data in one place for the enterprise to utilize, MedHOK triggers best practice interventions to improve quality of care.


    Improves Risk, Care, and Quality

    100% compliant with state and federal regulations, MedHOK delivers one system for the entire organization in order to succeed in value-based healthcare.




As a result of health reform, health plans and all risk-bearing entities will continue to experience the compounding impact of compliance as quality and risk demands expand the definition of compliance, including:

  • Medicare Advantage and Part D Audit Requirements
  • Heightened Focus on Health Plan Audits
  • Evolution of Value-Based Reimbursement Models

MedHOK delivers a comprehensive, integrated software solution that drives immediate and ongoing compliance. The MedHOK platform comes pre-configured with state and federal regulations, structured workflows, and analytics across all functionalities, creating an end-to-end platform that ensures consistent and timely enterprise-wide compliance.

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MedHOK’s SaaS-based platform leverages a single code base, allowing for a seamless end-to-end solution for healthcare payers. Our Service-Oriented Architecture (SOA) provides the ease-of-integration and interoperability that enables the secure exchange of health information across the organization.


Using Smart Connectors, MedHOK imports and normalizes data from multiple sources. Workflows, business rules, clinical rules, and dashboards are configurable by users. Smart logic enables the ability to easily view multiple lines of businesses and member/patients in one system to ensure compliance with government regulations.


The MedHOK platform’s flexible architecture enables real-time information sharing across to close gaps in care, improve care management and quality scores, and ensure worry free compliance with state and federal mandates. As a cloud-based system, proactive and agile updates to rapidly changing regulatory requirements are possible, transparent to the user.


Our Business Intelligence Rules engine creates robust, on-demand reports, including standard and regulatory reports, and audit-ready case summaries. Dashboards provide the status of key production and success metrics with real-time information. Built-in visual alerts and automated correspondence triggers assure compliance.


Based on a private cloud computing platform, MedHOK is highly efficient, securely shares resources, and is scalable to any volume with lower hardware costs. It allows for quick implementation driven by business teams, with minimal IT support. It is business user configurable, well-tested, and proven.


MedHOK supports healthcare industry standards such as HIPAA 4010 & 5010, NCPDP for Rx, HL7, SFTP, Web Services, Connect, and file exchange (PDF, RTF, flat files). Our servers are hosted in multiple locations throughout the U.S. in SSAE 16 certified data centers, with a default service availability agreement of 99.95%.

“The MedHOK platform has broad reach and modular functionality with the distinct ability to manage both medical and pharmacy care.”

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