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MedHOK MarketProminence

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

MarketProminence offers industry-leading enrollment processing, member maintenance, billing and reconciliation solutions that allow health plans to process and reconcile enrollment and payment at the member level, remediate differences to maximize revenue, and track expected revenue. With over 20 years in the industry, the MarketProminence solution is recognized as the leading platform for Medicare Advantage and Part D (MAPD) plans, helping plans meet the increasing complexities of CMS requirements. Collaborative, agile implementation and on-going support coupled with custom-configured workflow management design ensures a highly effective, compliant, and cost-efficient solution.

  • Offered as site-based or fully hosted SaaS solution
  • Fully compliant with CMS Medicare regulations
  • Out-of-the-box best practices workflows and processes
  • Highly configurable to meet a plan’s specific business rules
  • Seamless integration with plan claims systems and other third-party systems
  • Help Desk support available 24 hours a day, 7 days a week, 365 days a year
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Enrollment & Member Maintenance Solution

Streamline member enrollment and ensure compliance

The MarketProminence Enrollment & Member Maintenance solution comes out-of-the-box compliant with CMS Medicare rules and regulations and can be configured to meet state-specific Medicaid rules and business requirements.

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Financial Reconciliation

Reconcile expected versus actual government payments to maximize revenue

The MarketProminence Financial Reconciliation solution allows plans to reconcile enrollment and payment at the member level. This helps to remediate differences and maximize revenue, as well as track expected revenue moving forward at multiple plan levels.

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Premium Billing

Effectively manage premiums to ensure efficiency, accuracy, and member satisfaction

The MarketProminence Premium Billing solution enables health plans to perform accurate and timely premium billing processing. This solution also serves as an effective audit tool to produce required reporting and ensure compliance.

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Web Portals

Expedite enrollment applications through easy-to-use online portal solutions

We understand that health plans need a compliant online enrollment solution that’s easy to use. That’s why we developed MarketProminence Web Portals to meet the needs of the various types of users who need to apply for benefits online.

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MedHOK by the Numbers

20+

Years Serving Medicare & Medicaid 

More than 20 years serving Medicare, Medicaid, and other plans with MarketProminence solutions

7/15

MAPD 5-Star Contracts

7 of the 15 2018 MAPD 5-Star Contracts use MarketProminence

Featured Resources

Featured Blog

CMS Releases 2019 Plan Year Checklist

The Centers for Medicare and Medicaid Services (CMS) recently released its 2019 Plan Year Checklist.…

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Latest Blog Post

Enrollment Changes Hitting Medicare Advantage

With welcome season in October upon us, Medicare Advantage (MA) health plans are preparing for…

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Government Health Plans

Medicare Advantage Medicaid Status Report Best Way to Track True Medicaid Status

In response to our blog last week on Medicaid dual status identification, we had a…

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