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Standard case types

Updated on April 12, 2021
Pega Foundation for Healthcare Product Overview

Case TypeDescription
ComplaintsProvides end-to-end workflow processes to capture and manage member complaints.
CodesProvides end-to-end workflow processes to create, search, view, and maintain industry standard code sets and custom code groups in the Foundation.
UploadcodesProvides end-to-end workflow process for consuming change files on a weekly/ monthly/yearly frequency and updating versions for (HCPCS/CPT/ICD10) Codes.
Manage object model

Provides create and update workflows for managing the sample data objects available on the sample data admin portal, including:

  • Authorizations
  • Business Entities (Provider)
  • Claims
  • Companies
  • Employer Group Contracts
  • Members
  • Payers
  • Policies
  • Practitioners
  • Providers
  • Provider Contracts
  • Provider Networks
  • Provider Rate Sheets
  • Provider Pricing Arrangements

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