Blue Cross & Blue Shield of Rhode Island Selects Pegasystems to Improve its Customer Service

CAMBRIDGE, Mass., Mar 25, 2003 — Pegasystems Inc. (NASDAQ: PEGA), the only provider of smart, rules-based business process management (BPM) software, today announced that Blue Cross & Blue Shield of Rhode Island (BCBSRI) has selected its PegaHEALTH Member Services application to bring a higher level of customer service to its 650,000 members.

 

PegaHEALTH solutions address operational areas from claims automation to customer service, and are installed across 20% of the Blue Cross Blue Shield network, as well as at many other innovative healthcare and insurance organizations. Today, they help to improve customer service for nearly 40 million healthcare provider members around the world.

PegaHEALTH Member Services is a key component of the PegaHEALTH Service Manager suite of products, which enable healthcare payers to create integrated service centers — eliminating existing silos of data and information and helping to deliver consistent, high-quality service to both members and providers across the enterprise. PegaHEALTH Member Services automates common contact center service functions, from resolving claim inquiries to ordering ID cards and enrollment forms. It can help improve the speed of transactions while providing both consistency and a comprehensive view of all member contact experiences.

"Pegasystems was our hands-down choice, given its strong record of providing simple-to-use, yet powerful applications," said David Zink, Blue Cross & Blue Shield of Rhode Island's CIO. "Pegasystems will allow us to equip our customer service representatives with the data they need to deliver personalized and responsive service, while also automating specific processes and driving new value from our back-end systems. Pegasystems is providing us with a rock-solid platform for distinguished customer service."

"Effective contact center strategies don't just tally the number of calls handled, but instead seek a balance between controlling costs and supporting high-quality service," said Lauri Ingram, senior program director, META Group. "In addition to extending service operations and integrating a view to the Web, health payers should track how many first-time calls result in resolution. Measures such as these can help thwart problems that often manifest as customer complaints in the contact center."

PegaHEALTH Member Services intelligently guides customer service representatives (CSRs) through business processes to drive work to completion: providing data when and where it is needed. Customer data is retrieved from all pertinent legacy systems and multiple customer-contact channels — including phone, Web, interactive voice response, email, and fax — and then consolidated and displayed on a unified desktop. Management oversight is extended across customer service activities through comprehensive work management and reporting capabilities.

PegaHEALTH Member Services is also designed to deliver a rich set of HIPAA-specific functionality that is pre-configured to support today's HIPAA mandates, and flexible enough to incorporate future changes as new regulations are released. By using pre-configured healthcare best-practice rules, data models and interfaces, Pegasystems helps speed time to market with effective customer service and support. Pegasystems anticipates completing the customer contact center deployment at BCBSRI within six months.

"The PegaHEALTH products are designed to improve organizational performance and help achieve measurable return on investment by closing the gaps created by disconnected systems and providing organizations like Blue Cross & Blue Shield of Rhode Island with BPM solutions that provide long-term viability and success," said Tom Congoran, vice president of Pegasystems' healthcare business. "Blue Cross is bringing its customer service to the next level with a solution that extends across the enterprise."

About Blue Cross & Blue Shield of Rhode Island

Blue Cross & Blue Shield of Rhode Island has been the state's leading health insurer for 64 years and now covers more than 650,000 customers. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross & Blue Shield Association.

Forward-Looking Statements

Certain statements contained in this press release may be construed as "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995. The words "believe," "expect," "hope," "anticipate," "plan" and similar expressions identify forward-looking statements, which speak only as of the date the statement was made. The company does not undertake and specifically disclaims any obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. These statements are based on current expectations and assumptions and involve various risks and uncertainties, which could cause the Company's actual results to differ from those expressed in such forward-looking statements. These risks and uncertainties include impact of pending regulatory proceedings, difficulty in predicting the completion of product implementations and consequently the timing of revenue recognition, the inability to attract and retain key employees, reliance on key third-party relationships, management of the Company's growth, and other risks and uncertainties. Further information regarding these and other factors which could cause the Company's actual results to differ materially from any forward-looking statements contained in this press release is contained in the Company's Quarterly Report on Form 10K for the year ended December 31, 2002 on file with the Securities and Exchange Commission. Investors are cautioned not to place undue reliance on such forward-looking statements and there are no assurances that the matters contained in such statements will be achieved.

NOTE: Pegasystems is a registered trademark of Pegasystems Inc. Other product and company names may be trademarks of their respective owners.

About Pegasystems

Pegasystems (NASDAQ: PEGA) develops strategic applications for marketing, sales, service, and operations. Pega’s applications streamline critical business operations, connect enterprises to their customers seamlessly in real-time across channels, and adapt to meet rapidly changing requirements. Pega’s Global 3000 customers include many of the world’s most sophisticated and successful enterprises. Pega’s applications, available in the cloud or on-premises, are built on its unified Pega 7 platform, which uses visual tools to easily extend and change applications to meet clients’ strategic business needs. Pega’s clients report that Pega gives them the fastest time to value, extremely rapid deployment, efficient re-use, and global scale. For more information, please visit us at www.pega.com.

All trademarks are the property of their respective owners.

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.

 

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