Blue Cross and Blue Shield of Minnesota Selects Pegasystems BPM Software
CAMBRIDGE, Mass., May 15 — Pegasystems Inc. (Nasdaq: PEGA), the leader in unified process and rules technology, today announced that Blue Cross and Blue Shield of Minnesota has selected PegaRULES Process Commander® (PRPC) and Pegasystems' Healthcare Payer Industry Framework to help drive increased customer satisfaction by optimizing pharmacy claims operations and Medicare member enrollment processes.
"We selected Pegasystems for the depth of knowledge the company brings to healthcare and its proven history in delivering results," said Laurie Clark, vice president, Business Design & Enterprise Transactions of Blue Cross. "The flexibility offered by Pegasystems' rules-driven BPM platform will help us create agile solutions to best meet our members' needs."
The Payer Industry Framework includes several features and functions that accelerate the development of customized solutions for today's payer organizations' biggest challenges. Authorization and member process workflows, healthcare service levels, routing and decision rules, correspondence generation and Web service message intake and responses are all included in the framework. HIPAA EDI templates and a HIPAA-compliant healthcare data model round out the offering.
"The Payer Industry Framework provides best-practice work templates for rapidly creating SmartBPM solutions to deliver service, support growth and ensure compliance," said Mark Manning, sales director, Pegasystems. "By leveraging the pre-built foundational elements of the Payer Industry Framework with PRPC, Blue Cross and Blue Shield of Minnesota will be able to maintain strong relationships with their member and provider networks, while more rapidly responding to changes in the market."
About Blue Cross and Blue Shield of Minnesota
Blue Cross and Blue Shield of Minnesota, with headquarters in the St. Paul suburb of Eagan, was chartered in 1933 as Minnesota's first health plan and continues to carry out its charter mission today: to promote a wider, more economical and timely availability of health services for the people of Minnesota. A not-for-profit, taxable organization, Blue Cross is the largest health plan based in Minnesota, covering 2.6 million members in Minnesota and nationally through its health plans or plans administered by its affiliated companies. Blue Cross and Blue Shield of Minnesota is an independent licensee of the Blue Cross and Blue Shield Association, headquartered in Chicago. Go to http://www.bluecrossmn.com to learn more about Blue Cross and Blue Shield of Minnesota.