Healthcare 8.7 enhancements
In addition to the updates listed above in the Pega Customer Service 8.7 enhancements section, Pega Customer Service for Healthcare 8.7 includes the product enhancements that are described in this section.
For information about all customer service enhancements, see Pega Customer Service 8.7 enhancements.
Authorization Inquiry Microjourney
You can extend the Microjourney for similar use cases such as pharmacy coverage requests. Because this Microjourney is compliant with App Studio and is built by using the Customer Service Generic Template, you can implement the Microjourney with little customization, configure it in App Studio, and then add it to your self-service channels. The use of self-service channels can decrease the call volume in your organization.
You can also modify settings for this Microjourney in App Studio. Click .
Update PCP and Find Provider Microjourneys
In version 8.7, Pega Customer Service for Healthcare includes a new Update Primary Care Provider (PCP) Microjourney, which allows agents to add or update PCPs and a new Find Provider Microjourney, which allows agents to search for provider organizations or individual practitioners.
The Microjourneys are compliant with App Studio and are built by using the Customer Service Generic Template. Therefore, you can implement the Microjourneys with minimal customization, configure them in App Studio, and add them to self-service channels.
The existing Update PCP Microjourney and the Find Provider Microjourney are marked as deprecated but will be maintained by Pega for a limited number of releases. Eventually, Pega will remove them from the application.
Pega CME and DX API-compliant healthcare Microjourneys
Pega Customer Service™ Case Management Edition (CME) offers a customer service solution when you have not licensed the desktop. Clients can use modified out-of-the-box case types or modify existing case types and embed them into an external desktop or self-service portal. In version 8.7, Pega Customer Service for Healthcare includes the Claims Inquiry and Patient Assistance DX API-compliant healthcare Microjourneys™. The Microjourneys highlight case management features such as the data model, automation, duplicate check, policies, process logic, business conditions, validations, SLAs, integration, notifications, processing and approvals, security, and audit trail. Clients can extend these Microjourneys as needed.
For more information about the design methodologies, see Configuring your Pega Customer Service implementation application for Case Management Edition.
For Microjourney-specific information, see the following Wiki articles:
New prospect search group
In Pega Customer Service for Healthcare 8.7, a new search group, used in interactions, was added for sales prospects. which allows agents to search for provider organizations or individual practitioners. Contact centers can use this feature for agents who take calls from non-customers as well as customers.
For more information about configuring search fields, adding search views, and configuring search groups, see Customer search.
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