PEGA BPM CASE STUDY

PEGA Project Scenarios:
 Scenario:
Claims (Healthcare) Analyst System:- Includes Case Management/Claims Use Case UI Development/Email/Validations/Database tables/SLA Handling
The Healthcare Claims Solution is a design model showcasing how business edits can be configured, arranged, and maintained effectively to process claim files. It is important to understand that one of the key goals of the Claims Solution is to provide an alternative, efficient way to handle claims processing edits; especially those that change frequently and/or require a high level of custom programming effort on the main claims adjudication system(s). Also it primarily focuses on the Customer get the insurance claims redeemed based on the credibility and process with shortest turnaround as possible. 
Topics:
UI:
Properties, Harness
Sections and Layouts
Flow Action
Rule Resolution, Circumstancing, Rule Availability, Prerequisites
Case Management
Urgency, Service Levels (Agents)
Work Party, Work Status
Creating subcases, Locking


Integration
Connectors
Services
Database table mapping
Advanced Concepts
SMA
Agent Tracing
Product Rule
Specific topics can be included in further based on the clarifications and request.


Kindly contact us
Seetha
Technical consultant
9500092050



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