SOURCE: Pegasystems

Pegasystems

February 09, 2011 10:13 ET

Pegasystems Enables Healthcare Systems and Integrated Delivery Networks to Both Increase Cash Flow and Decrease Operational Costs

New Solution Reinforces Billing Accuracy, Increases 'First Pass' Rates

CAMBRIDGE, MA--(Marketwire - February 9, 2011) - Pegasystems Inc. (NASDAQ: PEGA), the leader in business process management (BPM) solutions, today announced its new Revenue Cycle Manager™ solution for the healthcare market. The new solution enables healthcare systems to streamline patient billing, boost cash flow and drive down operational costs by increasing the amount of clean bills produced at the outset.

The revenue cycle for U.S.-based healthcare systems, historically plagued by high error rates and long payment cycles, is under tremendous pressure to modernize. With federal mandates such as healthcare reform and the American Recovery and Reinvestment Act of 2009 intended to improve patient access and care, healthcare systems and integrated delivery networks are under further pressure to ensure accuracy in billing. By improving the percentage of clean bills generated at first issuance, these organizations can shrink the time and effort it takes to collect payments, prompting more timely resolution, improved accounts receivable and increased productivity.

Unlike legacy applications that focus on resolution at the end-stages of the revenue cycle, or point solutions that take limiting approaches at some stages, Pegasystems' Revenue Cycle Manager allows error correction at every stage. The solution, together with other Pega healthcare-focused solutions for care management, claims and customer service, enables:

  • Greater management visibility across operational silos, supporting real-time response to specific patient account and billing problems;
  • Improved management of the overall revenue cycle; and 
  • Increased staff productivity by standardizing and speeding error corrections data.

Pega's solutions are widely used by several leading healthcare delivery systems and major healthcare organizations including two of the largest healthcare provider systems, seven of the eight largest US health plans, two of the four largest pharmacy benefit managers, and several state and federal government agencies. Healthcare transactions for more than one of every two Americans, including members from over 60 percent of the Blues network, are processed with Pegasystems' technology.

Quote and Commentary:

Bill Marshall, Principal, Healthcare Industry Solutions, Pegasystems
"While healthcare systems have historically had a difficult time navigating the complex labyrinth of getting accurate patient bills processed and receiving payments in a timely manner, recent legislative mandates and tighter operating budgets have increased the need to take action. To better leverage aging legacy systems and overburdened staff, the industry must embrace solutions that meet the challenge head on and deliver sustainable business process improvement."

Supporting Resources:

For more information on this solution, visit: http://www.pega.com/resources/revenue-cycle-manager

For more information on Pega's healthcare-targeted solutions, visit: http://www.pega.com/industries/healthcare/bpm-for-healthcare.asp and http://www.pega.com/industries/healthcare/frameworks.asp

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About Pegasystems

Pegasystems, the leader in business process management solutions and a leading provider of CRM solutions, helps organizations enhance customer loyalty, generate new business, and improve productivity. Our patented Build for Change® technology speeds the delivery of critical business solutions by directly capturing business objectives and eliminating manual programming. Pegasystems enables clients to quickly adapt to changing business conditions in order to outperform the competition. For more information, please visit us at www.pega.com.

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The information contained in this press release is not a commitment, promise, or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described remains at the sole discretion of Pegasystems. Pegasystems specifically disclaims any liability with respect to this information.

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