Transform Patient Call Management into Patient-Focused Service

The challenge: The ever-growing volume of interactions and demand for services are testing the limits of providers to offer efficient, personalized patient call management. Traditional service technologies are too inflexible to meet the complex needs of today’s patients, driving up time and costs for service interactions.

With Pega, every patient interaction becomes an opportunity to deliver patient-focused service while achieving new levels of efficiency and productivity. Pega makes it easy to provide consistent, accurate answers and personalized service by turning best practices into intelligent processes that leverage automated guidance, holistic case management and real-time decisioning to tailor each interaction to the patient, situation, channel and care setting. The result is dynamic interactions that improve health outcomes, dramatically increase operational efficiency and automate compliance with constantly changing regulations.

• Increase one-and-done service calls. Unified multi-channel interaction management and intent-led processes dynamically guide staff and representatives through each step.
• Deliver patient-centered care at lower cost. Sophisticated predictive and adaptive analytics combined with Next Best Action decisioning personalize each response, promoting patient collaboration, increased savings and improved outcomes.
• Promote self-service and shared accountability. Intuitive self-service portals provide automated guidance and a universal patient view to facilitate better self-management.
• Optimize the experience. Business-focused tools rapidly turn service strategies into intelligent processes without any coding. Measure, simulate, adapt and change performance strategies in real time to immediately refocus the service experience.

Customer Success

Fast, High Quality Service with Pega One of the largest managed care organizations in the U.S. provides care through its extensive network of physicians, hospitals and medical offices. Using Pega to implement a comprehensive customer service solution that offers a 360-degree view of patients, the organization has increased first-call resolution by more than 90% while cutting average handle time and training time by 20%.