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Unified Interaction Portal

Updated on January 6, 2022

The enhancement of the Interaction Portal in Pega Care Management further aligns the application with the CRM work paradigm. This allows for access to features such as Interactive Voice Response with Intelligent Virtual Assistant (IVR-IVA), Chat, and outbound calling.

Pega Care Management Implementation Guide Pega Care Management Implementation Guide Pega Care Management Implementation Guide

The Home page typically contains information about the user, a menu along the left side, and various sections such as My cases and My workbaskets that display information to a CSR.

You can extend features in the Patient 360 profile. For additional information, see Configuring and extending features on the Patient 360 profile.

Dashboard

The dashboard, accessed in the left pane of Dev Studio, displays widgets with different reports. You can view the details of reports based your persona. Report categories include Performance, Interactions and cases, and Customer Satisfaction.

In Pega Care Management, dashboard widgets include the following types of reports:

Denials by MD (UM)
A circular chart that displays the percentage of denied authorizations.
Overturn of denials by MD
A pie chart that displays the percentages of overturned and denied appeals
Program referral status
A pie chart that displays the status of programs offered and the percentage of the programs that were denied.
Upcoming peer-to-peer reviews
A count of the open authorization reviews that are assigned to the doctor.
Visits scheduled
A list view that displays the visits scheduled by the CSR.
Auth reviews within SLA
A circular chart that displays the percentage of authorizaiton resolved within the time of the service level agreement.
Assessment status
A bar chart that displays the number of resolved and unresolved assessments.

For more information about the reports, see Customizing reports.

Navigation pane

The navigation pane is the left pane on the Home page. In Pega Care Management, the features that are displayed in the navigation pane are based on the persona.

For more information, see Persona access to the navigation pane.

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