MedHOK delivers an unparalleled 360-degree view of the Member, with real-time access to members’ complete medical and pharmacy care history, eligibility, benefits, demographics, provider info and all activities, interactions, documents, etc. in one repository, accessible from anywhere in the MedHOK platform.
Referred to as 360Member within the MedHOK software platform, 360Member provides an intuitive end-to-end history of each member. Every interaction, including prior authorization (processed by the health plan, provider or delegated entity), appeals, grievances, complaints, over-the-counter medication, clinical surveys, notes, correspondence, etc. are retained at the member level for easy retrieval and audits. Data inputs can be leveraged into member-specific diagnostic profiles with an emphasis on gaps in care, quality, and Hierarchical Condition Category (HCC)/risk adjustment data.
This member-centric approach shifts the focus from simply reporting quality measures to actually influencing results for a targeted population.
Our 360Member profile promotes a collaborative approach by providing a real-time, single view of all data and activities for each of your members so you can make the best, most informed decisions and actions for the member. Data from an organizations’ systems are added to the 360Member profile to provide all relevant claims, benefits, and eligibility data at the user’s fingertips.
The member is the center of value-based healthcare and MedHOK places the member at the center of your operations.
Improve Quality and Stars ratings by delivering world class member support.
Driving high Star ratings delivers greater revenue realization.
"With MedHOK, I am confident that we are providing our Members with the highest quality care possible."
Chief Executive Officer, National Health Plan