Hawaii Medical Service Association Selects Pegasystems to Improve Contact Center Operations and Drive Higher-Quality Customer Experience

CAMBRIDGE, Mass. – June 9, 2010 – Pegasystems Inc. (NASDAQ: PEGA), the leader in Business Process Management (BPM) software solutions, today announced that the largest provider of healthcare coverage in the state of Hawaii, the Hawaii Medical Service Association (HMSA), has selected Pegasystems to drive higher levels of service to both its members and provider network.  

Pegasystems’ Customer Process Manager for Healthcare (CPM-HC), built on the award-winning Pegasystems’ SmartBPM® platform, will also enable HMSA to decrease operational expenses by increasing first-call resolution times and automating service operations, such as correspondence and call wrap-up.

HMSA wanted a solution that would be easy to customize for its several different channels of customer service.  The organization chose Pegasystems over traditional customer relationship management (CRM) vendors due largely to Pegasystems’ blended approach to BPM and CRM.  Based on adopting this agile, build for change approach, HMSA anticipates significant ROI in several areas, such as:

  • Improved member and provider satisfaction
  • Improved accuracy and better reporting
  • Reduction in agent classroom training time
  • Increased employee satisfaction
  • Improved accountability and collaboration

Pegasystems’ CPM-HC delivers a rich framework of customer service processes that uses the power of Pegasystems’ advanced BPM technology to intelligently integrate application functions, essential enterprise customer data, and human tasks into efficient and streamlined customer-centric processes. The solution reduces average handling times through guided processes, dialoged scripting, and a 360-degree view of the caller’s history and pertinent health information. 

Pegasystems’ BPM solutions are widely used by major healthcare organizations, including the three largest U.S. health plans, two of the four largest pharmacy benefit managers, several leading healthcare delivery systems, and U.S. government agencies at the state and federal level.  Healthcare transactions for more than one of every two Americans, including members from more than 90 percent of the Blue Cross and Blue Shield Association network, are processed with Pegasystems technology.

 

 

 

Highlights/Key CPM-HC Solution Facts:

  • Intent-led processing – The system guides users through steps and processes based on a blending of both the organization’s and the customers’ goals.  Activity changes in real time based on actions taken during the interaction itself.
  • Interaction and activity management — The system delivers comprehensive, customer information to a single-screen view; eliminating time-consuming toggling between systems.
  • Channel management — The application provides consistent and seamless service across Web, e-mail, Computer Telephony Integration (CTI), Voice Response Unit (VRU), Interactive Voice Response (IVR), phone, and more.
  • Service automation— Rather than routing or escalating work for manual intervention, the technology uses pre-configured workflows to streamline common healthcare service requests, such as contract-maintenance transactions, benefit inquiries, claim-status inquiries, authorizations, etc., eliminating processing errors and decreasing member callbacks.
  • Offer management — Smart offer and scripts enable organizations to proactively offer new programs that promote retention, Web self-service, and wellness programs, which promote healthier, happier customers and lower medical costs.
  • Performance and compliance management — The solution extends managerial oversight across customer-service activities with comprehensive performance management, reporting, and self-documenting capabilities.
  • Change management — The system is easily updated by business users, allowing efficient personalization of processes in response to changing business conditions and market needs. 

 

Supporting Quotes:

 

Elizabeth Hart, Healthcare Principal, Pegasystems:

 

“Consumers give healthcare payers the lowest ranks for customer service across all major industries, which points to how traditional CRM has fallen short.  Forward-thinking healthcare organizations, such as HMSA and many other Blues affiliates, are now turning to Pegasystems’ solutions because we infuse process-centric capabilities, automation, and personalization into our service solutions.  This enables a better customer experience, not to mention significant cost savings.”

Alvin Kajiwara, Director, Enterprise Architecture, HMSA:

 

“We selected Pegasystems because of its strong guided process capabilities, a key feature for us.   Pegasystems also demonstrated that it brings a depth of knowledge to healthcare, and its flexible solution accommodates our unique needs.”

 

Supporting resources:

RSS Feeds for Pegasystems Press Releases, Pegasystems Media Coverage, Pegasystems Webcasts and Pegasystems Events

 

 

About HMSA

HMSA, an independent licensee of the Blue Cross and Blue Shield Association, is a reliable name in Hawaii health care.  Established in 1938, they are the largest and most experienced provider of health care coverage in the state.  Over half of Hawaii’s population has chosen HMSA for their health care coverage.  HMSA is dedicated to providing quality, affordable health plans; employee benefit services; and worksite wellness programs.  HMSA also offers a variety of programs, services and support to help improve the health and well-being of members and the community.

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.

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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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