Appeals & Grievances Reimagined

It’s time to rethink the appeals & grievances process! Leveraging qualitative interviews and conversations with leaders responsible for the A&G lifecycle across payer, provider, and pharmacy benefit manager (PBM) organizations, Pega took a closer look at some of the common challenges and pitfalls organizations face as they look to improve A&G processes. The following summarizes many of the recurrent pain points and offers insights into industry-proven solutions to help your organization overcome these hurdles at scale.