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MedHOK's Provider Disputes Solution
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Provider Disputes Solution

Solution Overview

MedHOK’s Provider Disputes solution is a pre-configured workflow solution for processing and tracking provider disputes. The system-defined workflow ensures that cases are processed consistently, and correspondence is triggered automatically and attached to the case. The Dashboard allows for real-time activity monitoring by management and promotes a proactive approach to caseload and compliance deadlines.


Customers use this solution to:

  • Take-in and process provider disputes of denied authorizations or claims payment in a timely and compliant fashion
  • Track dates to internal SLA to ensure premium provider service response
  • Improve provider relations via integrated collaboration with MedHOK Provider Portal

Have You Considered ...


With Provider Disputes, you may also want to manage related functionalities on one platform to ensure compliance, improve efficiency and productivity, and deliver better quality care. Consider adding these MedHOK solutions:

Download Product Spec Sheet

100% Compliant with Medicare, Medicaid, Commercial and Exchange

Ensure compliance with MedHOK's Unified Payer Platform, built from the ground up to be compliant from day one

Increase Star Ratings

Compliant and consistent handling of appeals, grievances and complaints can result in improved Star ratings, provider relationships, and member satisfaction

Based on Industry Best Practices

Automatic workflows based on industry best practices ensure cases are processed consistently and correspondence is triggered automatically

Request a Demo

Why do more than half of MedHOK's clients use the Provider Disputes solution?

Our clients represent some of the nation's largest and most prestigious health plans, PBMs, Specialty Pharmacies, and other payers. See for yourself why they rely on the MedHOK Unified Payer Platform for Provider Disputes. Please complete the form and let us know which capabilities you would like to see. One of our demo specialists will contact you to schedule your custom demo.

Provider Disputes Demo Request