Medical Mutual of Ohio Selects Pegasystems

Pegasystems technology to help improve customer service and streamline claims operations for health insurer

CAMBRIDGE, Mass. – July 17, 2012 – Pegasystems Inc. (NASDAQ: PEGA), the leader in Business Process Management (BPM) and software for customer centricity, today announced that Medical Mutual of Ohio will leverage Pega technology to modernize operations and drive higher quality customer service.  Renowned for its technical innovation and its commitment to customer care, Medical Mutual of Ohio is a mutual insurer that processes nearly 100,000 claims daily for more than 1.6 million members.

Cleveland-based Medical Mutual has been included in the InformationWeek 500 annual listing of the nation’s most innovative users of business technology for the past three years. With Pega, it will now be able to enhance the overall healthcare experience for its customers by driving improvements in several customer relationship management (CRM) and operational metrics, including first-call resolution rates, automatic claims adjudication rates, average call handling times and self-service utilization.  Pega’s Build for Change® technology will help Medical Mutual deliver more consistent and meaningful customer service by guiding interactions through an intuitive user interface, accelerating and automating manual processes, and enforcing dynamic business policies through easily maintained system rules.  Pega was selected based on several criteria including its ability to support:   

  • Integrated Desktops
  • Comprehensive Contact History
  • Contact Context Awareness
  • Strong Reporting Capabilities
  • Knowledge Management
  • Consideration for Additional Platforms
  • Business Integration

The implementation – Medical Mutual will leverage Pega Customer Process Manager for Healthcare, Claims Repair, and Claims Workstation+ solutions  – is part of a strategic initiative that will drive company-wide benefits.  Pegasystems technology is used by 13 of the 15 largest health payers, more than 65% of the Blues network, several leading provider organizations and many of the largest pharmacy benefit managers.

 

Quotes & Commentary:

Sue Tyler, Chief Experience Officer at Medical Mutual

“At Medical Mutual we take pride in our commitment to provide exceptional customer value. We understand the importance of powerful technology in improving service and efficiency for all of our customers.  We are confident that Pega will help us deliver on our service philosophy, creating peace of mind for our customers, through consistent and memorable customer experiences.”

Keith Dayton, Senior Director, Healthcare Solutions, for Pegasystems

“Medical Mutual of Ohio is embracing advanced technology at a crucial time when organizations need to simultaneously deliver exceptional customer service and radically shift their cost curves.  This customer-centric approach is transforming many healthcare organizations into more agile enterprises so they can keep up with today’s fast pace of change and emerging new priorities in healthcare.”

 

Supporting Resources: 

For more information on Pega’s healthcare solutions, visit: http://www.pega.com/solutions/by-industry/healthcare

For more information on Pega’s Collaborative Healthcare Summit taking place on Oct. 24 in Boston, visit: http://www.pega.com/solutions/by-industry/healthcare/summit

About Pegasystems

Pegasystems revolutionizes how leading organizations optimize customer experience and automate operations. Our patented Build for Change® technology empowers business people to create and evolve their critical business systems. Pegasystems is the recognized leader in business process management and is also ranked as a leader in customer relationship management software by leading industry analysts. For more information, please visit us at www.pega.com. 

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The information contained in this press release is not a commitment, promise, or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described remains at the sole discretion of Pegasystems, Pegasystems specifically disclaims any liability with respect to this information.