Healthcare Insures Navigate Fluid Landscape with Pegasystems' Solid Solutions

By Mini Swamy
TMCnet Contributor

Healthcare insurers are having a tough time; they have to combat the turbulence that health reform brings in its wake, tackle rising consumerism and initiate quality of care initiatives using outdated and inflexible CRM solutions. Pegasystems (News - Alert) has upgraded its customer process manager for healthcare (CPM-HC) to help payers navigate the challenges better.

"Today's healthcare organizations are undergoing rampant change," said Susan Taylor, business Line leader for Healthcare at Pegasystems, adding, "They face a constantly changing regulatory environment, increased competition and a far more demanding customer base.”

Built expressly for healthcare organizations, CPM-HC is a business process management solution that delivers multi-channel, intent-driven customer service to increase productivity, loyalty and growth. It is typically used to service member and provider inquiries.

With this solution, the software company will be in a position to help healthcare insurers handle the rapidly emerging demands in healthcare management. This can be leveraged by healthcare payers to drive higher first call resolution rates and lower call handling time, while optimizing the customer experience.

In addition, it will also allow payers to deliver an omni-channel experience through its "design once-deploy everywhere" model, providing users with a consistent experience, regardless of operating system or kind of device used. It also provides a better guided interaction for agents and enhances customer experience for members. As social interactions can be installed and added to the agent portals, they can be managed better.

Also, Pega Live Data ensures that agents have the right data, at the right time in the right place. This means that agents have the right answers at their fingertips, can cope better and enhance the whole engagement process.

“With such a fluid landscape, healthcare organizations need the power to change quickly to address evolving business requirements,” observed Taylor.

While Pegasystems’ suite of healthcare solutions  are primarily aimed at helping organizations achieve significant results in gaining new business, improving customer service, and driving operational effectiveness,  its CPM-HP solution is expected to help  healthcare organizations future proof their operations, while meeting their immediate needs today,