Cobalt Selects Pegasystems to Maximize its Claims Processing and Drive Down Operational Costs
CAMBRIDGE, Mass., April 2, 2003 — Pegasystems Inc. (NASDAQ: PEGA), a leading provider of simply smart business process management (BPM) software, today announced that Cobalt Corporation (NYSE: CBZ), one of the leading, publicly traded healthcare companies in the nation, will implement solutions from its PegaHEALTH Claims Automation suite of software products to help improve productivity and reduce costs in processing its healthcare claims. Cobalt Corporation is the Blue Cross & Blue Shield licensee for the state of Wisconsin and an independent licensee of the Blue Cross Blue Shield Association.
"Pegasystems was a clear choice because of its established history of providing scalable, performance-oriented solutions to its customers," said Kathy Ledvina, Cobalt's senior vice president, Health Operations & Medical Management. "We are confident that Pegasystems will help us become more responsive and productive by increasing our first-pass rate, reducing our pended claims inventory, and improving our exceptions handling process. Our staff is very excited about the opportunity to gain efficiencies through the use of the Pegasystems suite of products."
"The PegaHEALTH Claims Automation suite of products is designed to harness and extend the power of core operating systems used by healthcare organizations," said Tom Congoran, vice president, Healthcare, Pegasystems. "Our sophisticated pre-adjudication functionality helps to deliver demonstrable improvement by moving claims through our clients' adjudication systems. Our software also helps to automatically repair claims that are bounced back, without operator intervention. For remaining pended inventory, our software helps to make claims operators more efficient and provides their management with improved control."
Continued Congoran, "Products in the PegaHEALTH Claims Automation suite may typically be installed in 90–120 days and have, in several instances, provided productivity gains to clients within three weeks of installation."
Cobalt, who signed this agreement with Pegasystems in December, will implement PegaHEALTH Claims Filter, PegaHEALTH Claims Repair and PegaHEALTH Claims Workstation+ to help achieve an increased return on investment when processing its healthcare claims. PegaHEALTH Claims Filter provides decisioning capabilities that will help Cobalt increase its first-pass rate and reduce its dependency on external clearing houses. PegaHEALTH Claims Repair employs flexible, responsive business rules to drive the automatic resolution of high-volume and easily repairable pended claims — those that need further attention — which should help Cobalt increase timely claims resolution and free claims processing staff to concentrate on handling more complex claims. With PegaHEALTH Claims Workstation+, pended claims will be routed to individual processors based on Cobalt's own escalation criteria — criteria that can be changed quickly and easily by its claims management team. PegaHEALTH Claims Workstation+ will then guide the processor to finalize the claim through scripted workflow.
Cobalt Corporation is the Blue Cross & Blue Shield licensee for the state of Wisconsin and an independent licensee of the Blue Cross Blue Shield Association. It is one of the leading publicly traded healthcare companies in the nation, offering a diverse portfolio of complementary insurance and managed care products to employer, individual, insurer and government customers. Headquartered in Milwaukee, Cobalt Corporation (NYSE: CBZ) was formed by the combination of Blue Cross & Blue Shield United of Wisconsin and United Wisconsin Services, Inc. For more information, visit its site at www.cobaltcorporation.com.
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 Annual 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.
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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.
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