Optimized solutions for healthcare providers
Make every experience more patient-centric
Pega helps leading healthcare providers continuously assess and respond to patient and employee needs – for more effective, comprehensive, proactive journeys across every touchpoint. Deliver more personalized care experiences by bringing AI and automation into existing workflows.
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Streamline patient care coordination
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Empower better health outcomes with every interaction
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Remove barriers to comprehensive, integrated care
Featured customers
Learn how this international healthcare leader unified its platform, reducing staff effort by 90%.
Watch how Apria delivers an effective mobile user experience while seeing incredible ROI.
Patient engagement
Personalize every journey
Use each interaction to gain deeper understanding, earn trust, and drive whole-person care. By reassessing context in real time through useful health, administrative, and financial insights –providers can personalize patient experiences across touchpoints.
How we do it
- Unify patient experiences using continuously updated data and analytics
- Personalize engagement with industry-leading real-time decisioning and AI
- Serve empathetic next-best-actions that align with patients’ needs.
Customer service
Offer proactive care
Anticipate patient needs, recommend appropriate next steps, and engage in meaningful conversations – all while continuously adapting and optimizing these interactions in real time, across channels. Ensure every interaction is impactful, timely, and tailored to the patient.
How we do it
- Enhance care coordination with AI-driven relevant, informed interactions
- Anticipate needs on patients’ channels of choice for more cohesive care
- Get more from current systems by building in a layer of agility
Streamline operations
Create operational excellence
Duplicating efforts across systems takes away time that could be spent with patients. Seamlessly integrate AI and automation with existing systems, processes, and data to minimize manual tasks, reduce errors, and boost productivity – all in service of offering the best possible patient care.
How we do it
- Seamlessly connect work across the organization by unifying systems
- Analyze circumstances that result in deviation from optimized processes
- Deploy true self-optimizing workflows at an organization-wide scale
Integrated care coordination
Improve patient services
Combine advanced engagement with workflow automation to provide proactive, consistent, patient-centric experiences. Centralize medical services, approvals, and critical information along the care continuum to make the healthcare journey smoother at every step.
How we do it
- Tailor care plans and enhance outcomes using real-time, interconnected data
- Consolidate information to predict needs and proactively address care gaps
- Actively engage to ensure continuity of care and promote better outcomes
- Leverage FHIR integration with the EHR
Onboarding & enrollment
Simplify their first step
Streamline processes from patient registration and enrollment, to physician recruitment, onboarding, and retention. Reduce administrative work and costs and ensure the kind of day-one experience that builds loyalty. Simplify and accelerate admin so teams can focus on what matters.
How we do it
- Improve transparency with registration, enrollment, and onboarding insights
- Quickly adapt to specific operational requirements and regulations
- Enhance patient and physician experiences with prebuilt accelerators
Revenue cycle management
Streamline claims management
With claims denial volumes skyrocketing, providers need scalable processes that can effectively handle RCM pre-adjudication and claims-denial. Leverage the power of efficient, high-volume healthcare payer claims management software to augment your RCM for increased net revenue and decreased claims management costs.
How we do it
- Eliminate denials with pre-submission AI decisioning and workflow automation
- Respond quickly, intelligently, and efficiently to the denied claims that matter
- Increase responsiveness and agility of RCM with dynamic skills-based routing and event codes
