PegaWorld 2017: Express Scripts - Journey of the Coverage Reviews and Prior Authorization Process (Presentation)

Focusing on improving the Coverage Review and Prior Authorization process, Express Scripts embarked on a transformation journey in 2012. Their multi-pronged approach includes Call Center, Electronic Prior Authorization, and a multi-channel experience which are implemented on the Pega Platform. They will share their success story around this process, along with lessons learned and how they have developed a state-of-the-art monitoring and controls solution for Medicare TAT’s.