• Careers
  • Contact Us
  • Blog
  • REQUEST A DEMO
Platform-wide Functions
Home / Unified Payer Platform / Platform-wide Functions

Successful Results Through Actionable Data Driving Automated Workflows

Your data is only as valuable as what you can do with it. MedHOK enables healthcare organizations to take in data from multiple sources and turn it into actionable information through structured automated workflows that yield results. Simply put, MedHOK enables an end-to-end approach to delivering value.

  • Collect - Utilizing MedHOK's Smart Connect integration engine, healthcare organizations can collect data from multiple disparate systems in real-time, or batch process, to bring together the most comprehensive data sets available in the industry
  • Structure - Utilizing MedHOK's 360Member and 360Provider tools, data is structured into usable, searchable information centered around the member and provider so your team can make the best decisions surrounding member care
  • Alert - Utilizing My Day and Action Center, MedHOK users are alerted to cases that need attention in order to maintain compliance or require specific tasks to be completed
  • Automate - Utilizing any of MedHOK's Spectrum of Medical/Rx Care solutions, healthcare organizations can conduct automated structured workflows that yeild measurable results for any specific component of the continuum of care
  • Act - Utilizing tools such as Auto-Assignments and Auto-Forwarding to specific roles/users in the MedHOK Unified Payer Platform, your team can quickly conduct meaningful actions (such as intake, correspondence, effectuation and care plan activities) that facilitate premium care, drive quality outcomes and ensure compliance adherence
  • Report - Utilizing pre-built reports, product and enterprise dashboards, Productivity Center, and our built-in BI tool, clients can generate real-time reports and assess their productivity and compliance adherence at the click of a button

MedHOK's Unified Payer Platform provides everything you need to succeed in value-based healthcare and compliance. It's all right here. 

What We Do Graphic.png

INTEGRATE MULTIPLE DATA SOURCES

MedHOK can interface with many disparate systems to provide a single actionable platform

SUCCESSFULLY DELIVER RESULTS

Prioritize. Automate. Act.  Deliver quality outcomes through structured workflows

THE POWER TO KNOW

Create reports in real-time to know your members are receiving the best care and your organization is compliant

Platform-wide Functions

MedHOK takes data from multiple disparate sources and turns it into accessible, actionable information that delivers the industry's most complete 360-degree member profile.

Learn more about our Platform-wide capabilities by clicking the titles below.

A key aspect of MedHOK’s Unified Payer Platform is that users are able to gain a complete picture of a member’s care from one common area, 360Member.  360Member is the center-beam of the MedHOK Unified Payer Platform, facilitating a complete view of the member’s profile and care history and history of eligibility with one click.  All cases, including current and archived, are accessible from the 360Member area. All member data is available within one system, creating a comprehensive view of the member from the 360Member area.  Eligibility files are uploaded from files sent by Independent Health typically on a daily basis.

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, and more, in one repository, accessible from anywhere in the MedHOK platform.

Read more

A key aspect of MedHOK’s Unified Payer Platform is that users are able to gain a complete picture of a member’s care from one common area, 360Member.  360Member is the center-beam of the MedHOK Unified Payer Platform, facilitating a complete view of the member’s profile and care history and history of eligibility with one click.  All cases, including current and archived, are accessible from the 360Member area. All member data is available within one system, creating a comprehensive view of the member from the 360Member area.  Eligibility files are uploaded from files sent by Independent Health typically on a daily basis.

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, and more, in one repository, accessible from anywhere in the MedHOK platform.

Read more

MedHOK enables compliance reports from all major modules, providing a real-time assessment of compliance adherence and easily generates the required reports for CMS, NCQA and State Agency audit requests.  At the touch of a finger, health plans can generate compliance reports to better understand issues that are impacting compliance. Given the high stakes, potential fines, penalties and even risk for closure due to lack of compliance adherence, Compliance reporting is critical. Being unsure of your compliance adherence is being unsure of your business plan.

Reporting examples include:

  • Universe reports
  • ODAG/CDAG reports
  • Real-time dashboards
  • State-based Medicaid compliance reports
  • NCQA reports
  • HEDIS reports
  • Star quality measure reports

Read more

MedHOK's My Day functionalityallows you to view all tasks assigned to you that are due today or in next order of time sensitivity in order to ensure cases are handled in a timely manner and remain compliant.  My Day provides automated alerting and queueing of case workload on a per user basis ensuring cases are handled in a timely basis for compliance adherence.  My Day enables filtering based on the following variables: 
  • Care Plans
  • Referral
  • Contacts
  • Follow-Ups
  • Interventions
  • ICT Meeting

Read more

MedHOK enables automated correspondence functionality enabling letters and other communications to be auto-generated and tracked in the case record to ensure compliance and premium member service.  MedHOK enables a comprehensive range of correspondence functionality that are easy to use and pre-configurable to healthcare organizations' specific needs. Built into customized structured workflows, MedHOK correspondence drives operational efficiency and compliance adherence.

Read more

If a client is using separate, third-party Member Engagement or Quality Management systems, our Smart Connect technology allows for integration with these systems using industry standard APIs and protocols. MedHOK uses internally developed Smart Connecters to interface with third-party systems within a plan or outside of a plan (subcontractors, vendors, providers, etc.). These Smart Connecters can accept data in HIPAA compliant, EDI, HL7 ver. 2.x and 3.x, XML or proprietary format. MedHOK supports real-time data integration through web services as well as frequent batch processes.

MedHOK’s Smart Connect translation engine utilizes standards based HL7 to integrate with EMR systems. MedHOK has integrated with systems that modify elements of the HL7 stack if the vendor provides customized interface specifications. MedHOK supports SOAP and XML for many of our existing customers, and we are quickly able to interface with different toolkits. Through web services, MedHOK processes transactions in real-time to allow for real-time eligibility lookup, provider lookup, electronic prior authorization, and more.

Read more

White Paper

Focus on the Member: The Premise for Value-Based Healthcare

Value-based healthcare requires a focus on the Member, quite a shift from the provider-centric, transaction-focused models with which payers are familiar. This paper discusses how a focus on the member will result in better quality, care, and outcomes.

Fill out the form to the right to download the paper now.