Deliver a Higher Standard of Compliant, Patient-Centered Care

The Challenge: The unprecedented number and scope of federal mandates are dramatically altering the way providers deliver health services.  These requirements demand agile processes that enable providers to quickly and efficiently comply with ever-changing regulations, reduce costs and deliver an even higher standard of care.

With Pega, healthcare providers can achieve the level of flexibility needed to fully comply with government requirements while continuously enhancing the delivery of patient-centered care. Pega leverages and extends existing systems with intelligent processes that dynamically apply the right regulation at the right time and eliminate manual hand-offs by automatically connecting all of the people, systems, data and channels required to complete work.  The result is high-performance interactions that do away with manual and redundant effort, enabling providers to focus on the patient – not the process.

Learn more about Pega solutions for:

• Care Management –   This transformational solution for complex care management offers adaptable ways to define and deliver customized care plans through a unified portal for such functions as utilization, disease and case management as well as health and wellness programs.
• Revenue Cycle Management –   This revenue cycle management solution uses intelligent automation to bridge organizational silos, automate manual processes and increase billing accuracy by improving the ‘First Pass’ clean bill rate.
• Patient Call Management – Pega makes it easy to provide consistent, accurate answers and personalized service by turning best practices into intelligent, efficient processes that tailor each interaction to the patient, situation, channel and care setting.
• ICD-10 – Pega facilitates accurate ICD-10 coding with intent-led processes that guide users through the steps for determining the right code. Combined with conversion tables, reverse mapping, translation rule creation and ICD reporting and modeling, Pega helps healthcare organizations rapidly complete successful conversions from ICD-9.