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MedHOK Clinical Platform

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

Many health plans and PBMs operate on several different systems. These silos of information can limit quality of care and present significant process and compliance challenges. MedHOK’s Clinical Platform was designed to bring together vital information and all functionalities across the health member care journey into a single system.

The only platform that combines pharmacy and medical care, the MedHOK Clinical Platform was purposely built to improve member care while ensuring continual compliance with ever-changing regulations. Clients benefit from the most rigorous system in the industry and significantly reduce manual effort. With the MedHOK Clinical Platform, customers maximize efficiency with automated workflows, ensure compliance adherence, increase quality scores, improve provider and member engagement, and optimize the healthcare experience for its members.

  • Minimize risk associated with maintaining compliance
  • Improve Star ratings and increase membership and PMPY revenue
  • Achieve organizational alignment and cross-functional collaboration
  • Gain a comprehensive view of every member for optimal health outcomes
  • Reduce administrative expense with structured workflow and task automation

In one system, MedHOK delivers everything needed to succeed with value-based healthcare. The broader the use of the platform, the greater the transformation for the entire organization.

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Pharmacy Management Suite

Drive quality care and compliance for all pharmacy management activities

Bring together all pharmacy management activities, including integration with ePA vendors to ensure compliance timeliness, reduce administrative costs, and improve drug safety with MedHOK’s Pharmacy Management Solutions Suite.

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Complaints, Appeals & Grievances
(CAG) Suite

Address all member and provider resolutions in one platform

Ensure regulatory requirements are met and provider and member expectations are exceeded through end-to-end complaints, appeals, and grievances workflow with MedHOK’s Complaints, Appeals, and Grievances Solutions Suite.

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Care Management Suite

Align all medical management activities to drive high-quality member care

Improve care, quality, and compliance across all aspects of the member care journey with MedHOK’s Care Management Solutions Suite.

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Quality & Revenue Management Suite

Ensure premium quality to drive revenue realization

Enable member-centered premium care, compliance adherence, and quality measurement with MedHOK’s Quality and Revenue Management Solutions Suite.

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MedHOK by the Numbers

40%

4-STAR RATING

40% of all 4-star and above Medicare contracts use MedHOK solutions

33%

IMPROVEMENT IN STAFF EFFICIENCY

Replace manual processes with automation and built-in compliance timelines

Featured Resources

CAG

Will Fax Machines Be Relegated to the Dustbin of History?

Up until a few months ago, I had this decade-old fax machine sitting in my…

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CAG

2019 Policy Rule Means Host of Changes for Medicare Plans

While plans look predominantly at the annual Call Letter for guidance on policy changes, this…

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