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Pegasystems powers prior-authorization transformation at fast-growing PBM

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Dec 06 2010 | Author: Pegasystems Inc.

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Pegasystems powers prior-authorization transformation at fast-growing PBM

A major pharmacy benefits manager (PBM) has transformed its Prior Authorization system with Pega’s business process automation and real-time intelligence, resulting in a 55 percent reduction in cost per authorization, double-digit increases in contact center productivity and the delivery of memberfocused service.

Business Issue

After growing more than 100% in each of the past four years, a major PBM needed to overhaul its prior authorization system to cut costs and call times while delivering a member-centric service experience.

Solution

Real-time intelligent automation determines authorization approval, eliminating manual lookups in the call center and substantially reducing the number of pends.

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Pegasystems powers prior-authorization transformation at fast-growing PBM

Pegasystems®, General Inquiries: US: +1 (617) 374 9600 | UK: +44 (0) 118 9591150 | Australia: +61 (2) 9251 0566

Pegasystems is the leading provider of business process management (BPM) and customer relationship management (CRM) software solutions. Our BPM methodology and BPM services provides businesses with an unprecedented degree of agility by giving business users control over the business process management suite and reducing reliance on IT staff. With user-friendly design tools, intuitive business rules functionality, and automated programming, the Pega BPM suite is the ideal BPM platform for enterprise initiatives like business transformation, continuous process improvement, and business performance management. Our Build for Change technology also powers agile solutions to specific operational challenges, such as workflow management software, customer relationship management software, business process management software, business process management systems and business process outsourcing software; as well as CRM solutions including customer service software, call center software and customer relationship management systems. Pegasystems CRM applications and contact center software help transform the customer experience across all channels and touch points. With business CRM software and call center solutions from Pegasystems, companies can maximize the value of every call center CRM interaction.

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