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Pega Smart Claims Engine Foundation

  • Mission

    Pega Smart Claims Engine Foundation

    4 Modules

    2 heures 25 mins

    Pega Smart Claims Engine for Healthcare 8.7 Visible to: All users
  • An introduction to the Pega Smart Claims Engine™ for Healthcare application, this mission provides a high-level overview of the technology stack on...

Claim navigation in Pega Smart Claims Engine

  • Module

    Claim navigation in Pega Smart Claims Engine

    5 Rubriques

    1h 20 mins

    Pega Smart Claims Engine for Healthcare 8.6 Visible to: All users
  • This module details the claims user interface, describes the components of an Internal Control Number (ICN), reviews claim identifiers, and describes...

Implementing and deploying Pega Care Management

  • Module

    Implementing and deploying Pega Care Management

    6 Rubriques

    55 mins

    Pega Care Management 8.7 Visible to: All users
  • In this module, learn about the key concepts, and best practices when implementing and deploying the Pega Care Management™ application.

Medication Therapy Management

  • Module

    Medication Therapy Management

    2 Rubriques

    40 mins

    Visible to: All users
  • Medication Therapy Management (MTM) is a free program offered as part of Medicare Part D plans to certain members that meet specific criteria, as...

Pega Smart Claims Engine

  • Module

    Pega Smart Claims Engine

    3 Rubriques

    20 mins

    Visible to: All users
  • This module introduces Pega Smart Claims Engine™ for Healthcare and provides an overview of the features and functionality of the application. The...

Pega Smart Claims Engine components

  • Module

    Pega Smart Claims Engine components

    3 Rubriques

    35 mins

    Visible to: All users
  • This module introduces the components of an orchestration in Pega Smart Claims™ Engine for Healthcare.

Pega Smart Claims Engine implementation scenarios

  • Module

    Pega Smart Claims Engine implementation scenarios

    4 Rubriques

    40 mins

    Visible to: All users
  • The modularity of Pega Smart Claims Engine™ for Healthcare and its flexible orchestrations allows Smart Claims Engine to be implemented in a wide...

Smart Claims Engine product overview

  • Module

    Smart Claims Engine product overview

    3 Rubriques

    30 mins

    Visible to: All users
  • This module reviews the claims adjudication process and introduces the concept of event codes in Pega Smart Claims Engine™ for Healthcare. It also...

Working in the Patient 360 profile

  • Module

    Working in the Patient 360 profile

    8 Rubriques

    1h 35 mins

    Pega Care Management 8.7 Visible to: All users
  • Learn about the key concepts and best practices for configuring Patient 360, including setting the categories for tracking social determinants of...

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