MedHOK understands the unique challenges that health plans and healthcare organizations face, because most of our team have been there. Driven to solve these challenges, MedHOK has developed the industry’s only Unified Payer Platform (UPP), which brings together all continuum of care applications across medical and pharmaceutical disciplines to enable all major lines of business. MedHOK built the Unified Payer Platform from the ground up, starting with a solid foundation of compliance, to consolidate dozens of disparate applications into a single platform, enabling automated workflows, simplifying processes, improving productivity, and ensuring compliance.
MedHOK’s Unified Payer Platform gives you total control, and provides a strong foundation for adapting to value-based healthcare, a payment model that requires a focus on the member, collaboration and communication with providers and business partners, meeting compliance demands, and a system that facilitates these initiatives in order to increase revenue.
Click the sections below or the graphic for an overview of each component.
The following functionality comes standard as part of the Unified Payer Platform:
MedHOK unifies medical and pharmaceutical member information into one platform, fueling automated workflows and creating a true 360-degree view of the Member. The Medical/Rx Care components encompass a full range of care management functionalities including:
MedHOK’s Unified Payer Platform provides full-function member engagement through proactive functions such as Health Education and Outreach, as well as a range of responsive functions such as:
Success in value-based healthcare is not only measured in Stars, but in overall regulatory compliance, member satisfaction, audit preparation, and revenue realization. MedHOK enables Payers to become Five Star Success stories with Pay for Quality components including:
Collaboration and cooperation among all stakeholders is necessary in value-based healthcare. The MedHOK Unified Payer Platform enables healthcare payers to engage and build communities with members, providers, and business partners, with these functionalities:
MedHOK's Unified Payer Platform was built from the ground up with compliance as its foundation. With built-in rules and regulations, MedHOK is 100% out-of-the-box compliant with Medicare, Medicaid, Commercial and Exchange lines of business. Plus, because MedHOK is a Software as a Service (SaaS) application, compliance is proactively updated for perennial compliance adherence.
By Marc Ryan
A few blogs ago we told you about major Centers for Medicare and Medicaid Services (CMS) Civil Monetary Penalty (CMP) activity in 2017. Recently, CMS released its annual Program Audit Report for the prior year and, as we told you then, it shows enforcement and rigor are not slowing down.
NEW YORK AND PHILADELPHIA, June 19, 2018 – Hearst Health, a division of Hearst, and the Jefferson College of Population Health at Thomas Jefferson University today announced the panel of judges for the 2019 Hearst Health Prize. This annual award is given in recognition of outstanding achievement in managing or improving health in the United States. The winner will be awarded $100,000 and up to two finalists each will receive $25,000. Submissions are now being accepted through August 9, 2018. Please visit www.jefferson.edu/HearstHealthPrize for details.
Baltimore Marriott Inner Harbor at Camden Yards
Tuesday, June 19, 2018 - Thursday, June 21, 2018
Stop by our booth to learn how MedHOK clients can achieve a 30% improvement in staff efficiency by eliminating burdensome manual processes and replacing them with process automation and built-in compliance timelines.