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Our Solutions

Purposely built, innovative SaaS solutions to improve compliance, efficiency, quality, and care across all lines of business

Health plans and other risk-bearing entities have predominantly built their information systems to support a transaction-oriented, fee-for-service model, with the provider at the core. However, value-based healthcare turns this model upside down, putting the focus on the member, with quality measures driving reimbursements and revenue. The best way to succeed in the transition to value-based healthcare while adhering to rigorous compliance demands is with integrated technology that consolidates data, streamlines processes, and utilizes all information to automate and enable workflows based on best practices.

MedHOK’s mission is to drive better member care in a changing healthcare environment by bringing every care moment in a person’s health journey together through an integrated platform. Purposely built with continual innovation to meet market demands and changing requirements, MedHOK provides a strong foundation for compliance, efficiency, quality, and care across all lines of business.

  • Streamline disconnected and inefficient workflows
  • Eliminate the complexities of multiple fragmented systems
  • Achieve bi-directional integration with core claims systems
  • Reduce time-consuming efforts and data disparities that hinder compliance
  • Overcome limited and fragmented member data that leads to member dissatisfaction

MedHOK Clinical Platform

Achieve exceptional care, quality, and compliance through a member-centric platform

The only platform that combines pharmacy and medical care, the MedHOK Clinical Platform was purposely built to improve member care by closing care gaps while ensuring continual compliance with changing government regulations.

  • Pharmacy Management
  • Complaints, Appeals & Grievances (CAG)
  • Care Management
  • Quality & Revenue Management

MedHOK MarketProminence Platform

Meet the complexities of Medicare and Medicaid requirements, streamline processes, and maximize revenue

Meet the complexities of Medicare and Medicaid requirements, streamline processes, and maximize revenue with industry-leading enrollment processing, member maintenance, premium billing, and financial reconciliation with MedHOK MarketProminence.

  • Enrollment & Member Maintenance
  • Premium Billing
  • Financial Reconciliation
  • Web Portals
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