MHK Introduces New Appeals & Grievances Offering for Small Health Plans

Cost-effective solution via multi-tenant cloud architecture and secure data environment

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Apr 30, 2019, 11:30 ET

TAMPA, Fla., April 30, 2019 /PRNewswire/ -- MHK, formerly MedHOK – Medical House of Knowledge, part of the Hearst Health network, and a Tampa-based healthcare technology pioneer that helps health plans and other managed care providers deliver better member care by bringing all critical member data together into an integrated platform, announced today the introduction of MHK CareProminence™ SELECT Appeals & Grievances Suite for small health plans. Designed for Medicare, Medicaid, and Commercial health plans with less than 25,000 Medicare Advantage members or 100,000 total members, MHK CareProminence SELECT Appeals & Grievances Suite is a cost-effective solution that features multi-tenant cloud architecture with standardized, pre-configured workflows that drive compliance and streamline efficiency, HIPAA-secure infrastructure, and out-of-the-box capabilities.

MHK CareProminence SELECT Appeals & Grievances Suite is an efficient and affordable offering that delivers compliance without complex customization. The Suite includes the MHK Medical Appeals, MHK External Review (ExRM), MHK Grievances, and MHK Pharmacy Appeals (optional) solutions. Serving the industry with MHK's CareProminence Complaints, Appeals & Grievances (CAG) Suite since 2012, MHK recognized the need for small health plans to have access to the same type of capabilities but at a lower cost.

According to Marc Ryan, Chief Strategy and Compliance Officer, "The development of MHK CareProminence SELECT was driven by the need for small health plans to have access to the same quality solution that some of the nation's leading plans have enjoyed, with standardized configurations and workflows, driving a lower cost. Creating a multi-tenant architecture with a secure data environment allowed this dream to become a reality and now small plans can operate as efficiently and effectively as larger plans."

MHK CareProminence SELECT Appeals & Grievances Suite allows small health plans to create process efficiencies, ensure compliance adherence, improve quality of care and Star scores, enhance member and provider experience, and ensure success in delivering value-based healthcare. MHK is continuing to develop solutions for small and large health plans, PBMs, and provider organizations as part of its healthcare technology strategy.

About MHK (Formerly MedHOK – Medical House of Knowledge)
MHK, part of the Hearst Health network, is a Medical House of Knowledge, where care and knowledge converge. The only service provider that combines pharmacy and medical, MHK's mission is to drive better member care in a changing healthcare environment by bringing every care moment in a person's health journey together through an integrated platform. MHK is committed to helping health plans, PBMs, and provider organizations improve quality of care, enhance operational efficiency, maximize revenue, and meet compliance demands. Three of the top five and seven of the top ten health plans are served by MHK and forty percent of all 4-5 Star Medicare health plans utilize MHK solutions. For more information, visit mhk.com.

About Hearst Health
The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person's health journey. Each year in the U.S., care guidance from Hearst Health reaches 85 percent of discharged patients, 205 million insured individuals, 77 million home health visits and 3.2 billion dispensed prescriptions. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, MHK (formerly MedHOK – Medical House of Knowledge) and Hearst Health Ventures (www.hearsthealth.com). Hearst also holds a minority interest in the precision medicine and oncology analytics company M2Gen. Follow Hearst Health on Twitter @HearstHealth or LinkedIn @Hearst-Health.