Reduces the overall per-claim processing cost and improves operational efficiency. It also lays the foundation for processing potential point-of-care, real-time submissions in the future.
Increases engagement and provides claims operations users and policy managers with a sense of ownership of the adjudication system that results in active contributions to continuous improvement.
Optimizes network contracts by enabling appropriate reimbursements and improving implementation plans for upcoming regulations. Also, it helps teams avoid repetitive, low-value tasks and focus on higher-value work effort.
Virtusa’s Pega SCE is a platform that uses cognitive computing and machine learning to replace legacy claims platforms to improve straight-through processing, transparency and visibility, and business flexibility. The platform deploys a process-oriented solution to help companies move away from rigid and inflexible systems, high operational costs, and poor user experience.
Virtusa’s product engineering and innovation expertise ensure your organization gets the best out of Pega SCE. The platform helps streamline claims modernization with the following features:
Virtusa’s Pega SCE provides additional applications to the payer’s claims processing system to streamline workflow. The benefits of Pega SCE include:
Additional benefits include:
Virtusa’s Pega SCE guides clients through a complete journey of the claims modernization process. Your organization will benefit from simplified workflow and business flexibility by following the Pega SCE journey: