Pega Smart Claims Engine implementation scenarios

The modularity of Pega Smart Claims Engine™ for Healthcare and its flexible orchestrations allows Smart Claims Engine to be implemented in a wide variety of ways to address specific business problems. This module presents the most common Smart Claims Engine implementation scenarios.

Beginner

Healthcare

Healthcare Payer

English

After completing this module, you should be able to:

Describe the four most common implementation scenarios

Characterize the features of each implementation scenario

Explain the business problems solved by each approach

Available in the following mission:

Pega Smart Claims Engine Foundation v1

Topics

Pre-adjudication

10 mins

Post-adjudication

10 mins

External pend management

10 mins

End to end transformation

5 mins

Module Quiz

5 mins