Health Services

Modernize health program delivery and improve patient outcomes.

Maximus Canada’s Health Services support governments in delivering intelligently automated, compliant, and citizen-focused healthcare programs.

Whether managing complex claims or administering benefit programs, our solutions are designed to meet the evolving needs of public health systems.

Our Solutions:

  • Medigent
  • Health Program Administration

How it helps

We apply the people, processes, and technology to help clients efficiently manage their public health care programs.

Maximus transforms health program delivery with seamless enrolment, claims processing, and administrative systems that deliver automation, efficiency, privacy and cost savings.

Our Health Services help government clients:

  • Digitize and streamline claims adjudication and payment cycles
  • Improve medication safety and prescription tracking
  • Automate workflows for benefit eligibility and enrolment
  • Support jurisdiction-specific rules and reporting standards
  • Enhance citizen access to health services through modern platforms and digital interfaces

Improve public health care outcomes and reduce budgetary burdens with advanced health care administration and technology, supported by the Medigent platform.

  • Jurisdiction-specific business rules and automation
  • Real-time drug utilization review and e-prescribing
  • End-to-end support for health program operations
  • Integration with financial and health record systems
  • Modular, scalable, design for phased modernization
  • Proven delivery across multiple jurisdictions across Canada and the Caribbean

Medigent

Modernize, automate, and transform public-sector health services with Maximus Canada's modular health administration system. Our industry-leading platform provides a scalable solution for beneficiaries and providers, and can be deployed individually or in any combination required.

Our solutions are founded on robust business rules specific to each jurisdiction. Users can configure the system with advanced rules development, which reduces the need for manual assessment of claims.

Medigent modules

Update aging medical and pharmaceutical systems with modules customized to your needs.

Medical

Adjudicates physician and hospital claims, supports multiple payment types, and integrates with financial systems.

Dental

Submit and adjudicate claims in real-time and batch, applying business and financial rules and fee code structures.

Pharmacy & Supplementary Benefits

Automates drug insurance workflows and supports real-time claims.

Medical Transportation

Tracks travel expenses and links vendor invoices to authorizations.

Reciprocal Billing

Manages inter-jurisdictional claims and reimbursements.

Beneficiary Enrolment

A full set of point-of-service beneficiary management administrative functions, including client information and eligibility management, health card services and client communication.

Provider Portal

Enables self-service and the secure management of information for registered practitioners and health care administrators. 

Drug Information System

Keep patients safe and informed, protect pharmacists from fraud, and give practitioners real-time access to patient prescription information.

Learn more about Medigent

Program Administration

For over 20 years, Maximus has been trusted with providing comprehensive support for health program operations, including:

  • Eligibility and enrolment
  • Program management
  • Citizen engagement and support through omnichannel contact centres
  • Document management
  • Account management
  • Claims management and payment
  • Information technology
  • Corporate support services
Learn more about our Eligibility & Enrolment services

Health by the numbers

100%

client retention rate across Canada and the Caribbean for the Medigent Platform

2.6

million + Ontario Drug Benefit recipients with access to omnichannel support services

10

million+ Medical, Pharmacy, Dental, and Travel claims processed annually with Medigent

As Canadians, our public health system reflects our national identity and is a cornerstone of our country’s legacy. We have a shared responsibility to preserve and strengthen it, not only for today’s beneficiaries, but for generations to come. Maximus is proud to partner with jurisdictions across Canada to deliver and modernize these vital services, ensuring they remain resilient, accessible, and future-ready.
Roger Fabi National Vice President, Business Process Services