MHK MarketProminence is a fully hosted SaaS platform designed for Medicare Advantage health plans to manage member enrollment, premium billing, and financial reconciliation. The platform streamlines complex administrative processes, automates up to 95% of records through CMS-compliant pre-enrollment workflows, and ensures ongoing compliance with evolving CMS regulations. MarketProminence supports both electronic and paper applications, automates eligibility validation, and manages member maintenance tasks such as address changes, premium updates, and disenrollments. It features built-in automated correspondence templates, seamless integration with claims and third-party systems, and highly configurable workflows to meet specific business rules. The platform provides 24/7 help desk support and is guided by subject matter experts, enabling health plans to maximize revenue, improve member communication, and maintain audit readiness.

Key Features

Automated Member Enrollment & Maintenance Streamlines and automates the entire enrollment and member maintenance process.

• Processes electronic and paper applications
• Validates eligibility and manages ongoing updates

Premium Billing & Financial Reconciliation Automates billing and reconciliation at the member level.

• Tracks expected revenue and remediates differences
• Integrates with claims and financial systems

Compliance Management Ensures adherence to CMS Medicare regulations.

• Out-of-the-box compliant workflows
• Automated regulatory correspondence templates

Highly Configurable Workflows Adapts to specific business rules and operational needs.

• Custom-configured workflow management
• Flexible integration with third-party systems

24/7 Help Desk Support Provides continuous support for users.

• Available 365 days a year
• Expert guidance and troubleshooting

Benefits

Operational Efficiency Reduces manual effort and administrative burden.

• Automates up to 95% of pre-enrollment processing
• Frees resources for member satisfaction and health initiatives

Regulatory Compliance Minimizes risk and ensures audit readiness.

• Built-in compliance with CMS rules
• Automated, accurate member communications

Revenue Optimization Maximizes revenue through accurate reconciliation.

• Tracks and remediates payment differences
• Supports financial stability

Scalability and Flexibility Supports plans of all sizes and adapts to changing needs.

• Highly customizable workflows
• Seamless integration with existing systems