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MHK Introduces the SmartProminence AI Suite

MHK, recognized as a key player in healthcare technology and part of the Hearst Health network, has unveiled its latest offering: the SmartProminence solution suite. This cutting-edge suite is designed specifically for health plans and pharmacy benefit managers, enhancing operational capabilities with AI-powered features.

The primary goal of SmartProminence is to streamline essential workflows in areas such as Utilization Management (UM), Complaints, Appeals, and Grievances (CAG), alongside Pharmacy Management. This innovative suite aims to help healthcare organizations achieve operational excellence while ensuring compliance and improved member outcomes.

The advent of SmartProminence comes at a critical time when healthcare entities are navigating the delicate balance between maintaining clinical appropriateness, adhering to regulatory demands, and enhancing member experiences amid tightening resources. According to Dr. Maurice Herbelin, Chief Medical Officer at MHK, the evolving needs of healthcare organizations prompted the development of these AI solutions. "Our SmartProminence AI solutions enhance the organization's ability to make timely, accurate, and evidence-based decisions," he states. This automation allows care teams to focus on engaging members more effectively, thus enriching their interactions and supporting overall compliance and cost containment goals.

Key Features of the SmartProminence Suite

The SmartProminence suite is equipped with multiple features designed to significantly improve efficiency:

1. AI-Powered Fax Intake: The suite introduces AI capabilities for fax intake, capable of automatically capturing, classifying, and routing prior authorization requests. This innovation minimizes manual entry and streamlines processing, making it easier to handle complex faxes and manage multifaceted requests. MHK will roll out these capabilities across its Utilization Management, Pharmacy Management, and CAG solutions starting in the first quarter of 2026.

2. Compliance Guardrails: Built-in features comply with the Centers for Medicare & Medicaid Services (CMS) and National Committee for Quality Assurance (NCQA) standards, keeping organizations audit-ready and compliant with state-level requirements.

3. Actionable Insights: MHK’s suite includes the CareProminence DataVisor®, a powerful AI-driven analytics tool that provides real-time insights into health plan performance and regulatory compliance. This feature equips payers with dynamic dashboards and reporting capabilities to effectively manage care quality and operational outcomes proactively.

MHK emphasizes that operational excellence transcends mere efficiency; it involves empowering health plans and pharmacy benefit managers to deliver consistent and high-quality outcomes. According to Conor Bagnell, President of MHK, by integrating AI into their portfolio and merging insights with advanced analytical tools like DataVisor, organizations can simplify complex processes, thereby enhancing operational efficiency.

With the launch of the SmartProminence suite, MHK reaffirms its dedication to enabling payers and pharmacy benefit managers to navigate the complexities of healthcare efficiently. This initiative is aligned with MHK's overall vision to reduce unnecessary human interventions in processes while focusing on value-driven interactions that truly benefit members.

About MHK

MHK, previously known as MedHOK, is a prominent provider of software as a service (SaaS) solutions tailored for health plans, pharmacy benefit managers, and provider-sponsored organizations. Headquartered in Tampa, Florida, MHK’s platforms are instrumental in supporting diverse areas such as utilization management, case management, population health, pharmacy management, enrollment, and regulatory compliance. By collaborating with payers nationwide, MHK strives to optimize operations, enhance outcomes, and deliver exceptional experiences for members.