Health Care Case Studies

14 Mar 18

Fortune 100 Healthcare Client needed a good Customer Service application

Designed and Developed a Customer Service application to reduce member and provider call processing times and to improve user efficiency. This application serves as a one stop shop for members and providers with inquiries, ID cards, material requests, eligibility, updates, enrollment, claims and billing.

Fortune 500 Healthcare Client needed an upgraded Appeals and Grievances system

Enhanced the member experience with regard to the Appeals and Grievances process. Re-Architected and Upgraded to the latest Pega version 7.x to improve performance and usability as well as to address existing shortcomings in the application.

Fortune 50 Healthcare Client needed a best-in-class Pharmacy support system

Developed an end to end Pharmacy Home System to support, map and monitor a beneficiary to a particular pharmacy.

Fortune 100 Healthcare Client needed a best Appeals and Grievances system

Designed and developed a Case Management Solution to handle unique Appeals and Complaints process flows of different Lines Of Businesses. This eliminated the manual effort required to comply with Federal SLAs and ultimately avoid fines and penalties.

Fortune 500 Healthcare Client needed a good product offering system

Enabled Cloud and Real time data integration for improved HealthCare service offerings and data usage points.

Fortune 500 Healthcare Client needed an upgraded Group Sales Management system

Redesigned the Group Sales Management system by automating the new group enrollment, renewal, group contract changes, quote management and underwriting processes.

Fortune 500 Healthcare Client needed an upgraded customer service system

Enhanced the Omni channel customer service experience for current users and added new users as part of M & A. Integrated with new enterprise systems and upgraded to the latest Pega Customer Service Framework from their legacy Customer Process Framework.