Links may not function; however, this content may be relevant to outdated versions of the product.
Pega Care Management reports
The Pega Care Management application includes the reports that are described in this article. You can view these reports in the My Reports tab in the CM Care Manager or UM Service Manager portals and get the details of a specific report by clicking the links for the line items.
For information about additional reports available in all Pega applications, see Standard reports and categories.
For information about building reports, see Working with the Report Browser.
Report categories include:
Pega Care Management reports for healthcare
This category includes reports that give you the ability to monitor, manage, and measure care management processes.
Report name | Rule name | Report description |
|---|---|---|
| Programs by case type | ACTIVEPROGRAMSBYCLINICALTYPE | Active programs that are categorized by clinical type |
| Patient goals | PATIENTGOALS | Patient goals and status |
| Patient alerts | PATIENTALERTS | Active alerts that are categorized by patient |
| Count care plan instances grouped by care plan category, status | CAREPLANSBYPROGRAMBYSTATUS ALL | Patients that are enrolled in care plans and categorized by care plan, category, and status |
| Care plans by date | CAREPLANSBYDATE | Care plans that are categorized by date |
| Active care plans by program | ACTIVEPATIENTSBYPROGRAM | Active care plans that are categorized by program |
| Active members by program | ACTIVEMEMBERSBYPROGRAM | Active members that are categorized by program |
| Active cases by owner | ACTIVEADMCASESBYOWNERREPORT | Active care management cases that are categorized by owner |
| Active case by case type | ACTIVECMCASESBYCASETYPE | Active care management cases that are categorized by case type |
| Active admissions by case type | ACTIVEADMISSIONSBYCASETYPE | Active admissions that are categorized by case type |
UM reports
This category includes Utilization Management (UM) reports that give you the ability to monitor, manage, and measure utilization management processes and timeliness.
| Report name | Rule name | Report description |
|---|---|---|
| Auth requests by status – Current year | AUTHREQBYSTATUS | Admission requests and status for the current year |
| Pending authorization requests by request type & pend status | PENDINGAUTHREQBYREQUESTTYPEPENDSTATUS | Pending authorization requests that are categorized by the request type and the pend status |
| Open discharge reviews | OPENDISCHARGEREVIEWS | List of open discharge reviews |
| Open concurrent reviews | OPENCONCURRENTREVIEWS | List of open concurrent reviews |
| Discharge census on daily basis | DISCHARGECENSUSFORUM | List of discharged patients on a daily basis |
| Denied auth by auth type and reject reason code – Current year | DENIEDAUTHREQ_CURRENTYEAR | Denied authorizations that are categorized by the authorization type and the reject reason for the year |
| Denied admissions by reject reason code – Current year | DENIEDAUTHREQAR_CURRENTYEAR | Denied admissions that are categorized by the reject reason for the current year |
| Authorization Requests by Request Type & Status – Current Year | AUTHREQBYREQUESTTYPE STATUS_CURRENTYEAR | Authorization requests that are categorized by the request type and the status for the current year |
| Authorization Requests by Request Type & Status – Current Month | AUTHREQBYREQUEST TYPESTATUS_CURRENTMONTH | Authorization requests that are categorized by the request type and the status for the current month |
| Authorization Requests by Request Type - Current Year | AUTHREQBYREQUEST TYPE_CURRENTYEAR | Authorization requests that are categorized by the request type for the current year |
| Authorization Requests by Request Type - Current Month | AUTHORIZATIONREQBYREQUEST TYPE_CURRENTMONTH | Authorization requests that are categorized by the request type for the current month |
| Approved Admissions – No Notification | APPROVEDADMISSIONS | Approved admissions |
| Admission census on a daily basis | ADMISSIONCENSUS ONDAILYBASIS | Reported admissions and discharges for today |
| Admission census | ADMISSIONCENSUS | Reported admissions that are being followed by the organization |
| Admission auth requests by status - Current year | ADMISSIONAUTHREQ BYSTATUS_CURRENTYEAR | Admission requests and status for the current year |
Incident reports
This category includes reports that are related to incidents. Because incidents are considered quality events, in many cases, you must report them to regulatory agencies. This report helps you to document and report incidents accurately so that you deliver a quality program and avoid regulatory penalties.
Report name | Rule name | Report description |
|---|---|---|
Incident report by date | GETREPORTSBYDATE | Incidents that are categorized by date, including the patient name and the details of the incident |
Previous topic Pega Care Management deprecated rules