Pega Product Composer for Healthcare streamlines the configuration and maintenance of health insurance products through guided assembly and reuse of atomic-level benefit components. These components can be fine-tuned for complex logic and conditions that include tools such as life-cycle management and versioning.
By simplifying product design, management, and delivery, Pega Product Composer for Healthcare unlocks product innovation, accelerates compliance, and speeds time to market. The application provides a centralized product repository that exchanges accurate, detailed plan and benefit information among all your users, systems, channels, and devices. This operational support results in accurate claim determinations and benefit quoting, and delivery of exceptional customer experiences. Health plans, integrated delivery networks (IDNs), and accountable care organizations (ACOs) can transform their product approach with Pega Product Composer for Healthcare.
Deployed on the cloud or on the premises, Pega Product Composer for Healthcare reduces time, cost, and risk for product development and execution.
Health insurers need new competencies to perform in today’s disruptive market. Rapid product development and efficient execution are essential for achieving regulatory compliance and winning members. Enhanced customer engagement across all sales and service transactions is critical to fulfill product promises, differentiate the brand, and grow the customer base. Organizations need the ability to service what they sell. Consumers demand access to accurate benefit information in the format of choice at their convenience, accurate claims adjudication in a timely manner, and experiences consistent with the product that they purchased.
For additional information, see the Product Overview on the Pega Product Composer for Healthcare product page.
- Application stack
- General settings
- Summary of Benefits and Coverage template
- Configuration settings for the SBC template
- Life cycle of the SBC template
- Accessing the Document management portal
- SBC template
- Managing the SBC templates
- Approving the SBC template
- SBC inheritance
- SBC error messages
- Entity configuration
- Life cycle management
- Updating Product Composer for Healthcare entities
- Bulk renewal
- Importing Pega Product Composer for Healthcare entities
- Generating a flattened structure for plan and product data
- How to auto flatten products and plans
- Extracting Pega Product Composer for Healthcare data and generating reports
- Extending the Pega Product Composer for Healthcare application
- Extending union data
- Customized reports
- Testing and deploying an application
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