PegaCARE and PegaCARE-Blue from Pegasystems Inc. (Customer relationship management for health care providers)
Platforms: Windows NT, AIX, VMS, Solaris, MVS CICS, HP/UX, Novell, DEC UNIX
Price: contact vendor for price
Customer relationship management solutions specifically tailored to meet the needs of health care providers. PegaCARE and PegaCARE-Blue are designed to help health care organizations: Improve the efficiency and accuracy of claims processing; Reduce response times in handling telephone inquiries by members and service providers; Deliver patient, member, payer, and provider information all to a single screen for call center operations; Reduce the training and associated costs for service reps; and Improve their quality of patient care by providing a platform for customer interaction that supports the entire health care cycle of pre-encounter, decision-making, episodic care, and clinical outcome with knowledge-based, best practices scenarios.

These suites of customer relationship management applications are for HMOs, PPOs, other managed care organizations, and health insurers. These applications automate workflow processes in many areas including benefits, payments, claims validation, and customer inquiries and integrate them into the companies' call centers, where customer service representatives manage patient care and field member and provider inquiries.

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