Article

Pega Care Management reports

The Pega Care Management application includes the reports that are described in this article. You can view these reports in the My Reports tab in the CM Care Manager or UM Service Manager portals and get the details of a specific report by clicking the links for the line items.

For information about additional reports available in all Pega applications, see Standard reports and categories.

For information about building reports, see Working with the Report Browser.

Report categories include:

Pega Care Management reports for healthcare

This category includes reports that give you the ability to monitor, manage, and measure care management processes.

Report name

Rule name

Report description

Programs by case typeACTIVEPROGRAMSBYCLINICALTYPEActive programs that are categorized by clinical type
Patient goalsPATIENTGOALSPatient goals and status
Patient alertsPATIENTALERTS

Active alerts that are categorized by patient

Count care plan instances grouped by care plan category, statusCAREPLANSBYPROGRAMBYSTATUS ALLPatients that are enrolled in care plans and categorized by care plan, category, and status
Care plans by date

CAREPLANSBYDATE

Care plans that are categorized by date
Active care plans by programACTIVEPATIENTSBYPROGRAMActive care plans that are categorized by program
Active members by programACTIVEMEMBERSBYPROGRAMActive members that are categorized by program
Active cases by ownerACTIVEADMCASESBYOWNERREPORTActive care management cases that are categorized by owner
Active case by case typeACTIVECMCASESBYCASETYPEActive care management cases that are categorized by case type
Active admissions by case typeACTIVEADMISSIONSBYCASETYPEActive admissions that are categorized by case type

UM reports

This category includes Utilization Management (UM) reports that give you the ability to monitor, manage, and measure utilization management processes and timeliness.

Report nameRule nameReport description
Auth requests by status – Current yearAUTHREQBYSTATUSAdmission requests and status for the current year
Pending authorization requests by request type & pend status

PENDINGAUTHREQBYREQUESTTYPEPENDSTATUS

Pending authorization requests that are categorized by the request type and the pend status
Open discharge reviewsOPENDISCHARGEREVIEWSList of open discharge reviews
Open concurrent reviewsOPENCONCURRENTREVIEWSList of open concurrent reviews
Discharge census on daily basisDISCHARGECENSUSFORUMList of discharged patients on a daily basis
Denied auth by auth type and reject reason code – Current yearDENIEDAUTHREQ_CURRENTYEARDenied authorizations that are categorized by the authorization type and the reject reason for the year
Denied admissions by reject reason code – Current yearDENIEDAUTHREQAR_CURRENTYEARDenied admissions that are categorized by the reject reason for the current year
Authorization Requests by Request Type & Status – Current YearAUTHREQBYREQUESTTYPE
STATUS_CURRENTYEAR
Authorization requests that are categorized by the request type and the status for the current year
Authorization Requests by Request Type & Status – Current MonthAUTHREQBYREQUEST
TYPESTATUS_CURRENTMONTH
Authorization requests that are categorized by the request type and the status for the current month
Authorization Requests by Request Type - Current YearAUTHREQBYREQUEST
TYPE_CURRENTYEAR
Authorization requests that are categorized by the request type for the current year
Authorization Requests by Request Type - Current MonthAUTHORIZATIONREQBYREQUEST
TYPE_CURRENTMONTH
Authorization requests that are categorized by the request type for the current month
Approved Admissions – No NotificationAPPROVEDADMISSIONSApproved admissions
Admission census on a daily basisADMISSIONCENSUS
ONDAILYBASIS
Reported admissions and discharges for today
Admission censusADMISSIONCENSUS

Reported admissions that are being followed by the organization

Admission auth requests by status - Current yearADMISSIONAUTHREQ
BYSTATUS_CURRENTYEAR
Admission requests and status for the current year

Incident reports

This category includes reports that are related to incidents. Because incidents are considered quality events, in many cases, you must report them to regulatory agencies. This report helps you to document and report incidents accurately so that you deliver a quality program and avoid regulatory penalties.

Report name

Rule name

Report description

Incident report by date

GETREPORTSBYDATE

Incidents that are categorized by date, including the patient name and the details of the incident

Tags:

Published July 29, 2016 — Updated March 22, 2019

Have a question? Get answers now.

Visit the Pega Support Community to ask questions, engage in discussions, and help others.