Video
Catamaran: Fighting Healthcare Fraud, Waste and Abuse on Pega Cloud
The Business Issue
One of the largest pharmacy benefit management companies in the U.S., Catamaran was forced to reevaluate its IT systems because of a new Center for Medicare and Medicaid Services mandate. The mandate called for Catamaran to eliminate fraud, waste and abuse and safeguard member health.
The Solution
Catamaran used Pega's Healthcare Industry Foundation on Pega Cloud to deliver a suspicious case-handling system for pharmaceutical claims for both Commercial and Medicare Part D members.
The Results
In less than four months, the new health management system was up and running, delivering these results:
- Decreased turnaround time
- Easier auditability
- Decreased manual touchpoints
- Improved scalability, efficiency and accuracy
Tags
Related Resources
-
Video
What’s Next? 5 Tech Trends Shaping the Future
-
Infographic
How the future of work changed in 2020 (Healthcare)
-
Research and Insights
Scale your customer service without limits on Pega Cloud
![AI in Innovation](https://www.pega.com/sites/default/files/styles/1024/public/media/images/2023-11/ai-innovation-prev-card.png?itok=I5cCWnoL)
Unleash the power of AI innovation
Learn about enterprise AI and how it'll drive the future of business outcomes.
![Why Pega](https://www.pega.com/sites/default/files/styles/1024/public/media/images/2021-07/why-pega-preview-card.jpg?itok=ovPGRTVn)
Why Pega?
Uniquely powerful software isn’t the only thing that sets us apart.