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 type ACTIVEPROGRAMSBYCLINICALTYPE Active programs that are categorized by clinical type
Patient goals PATIENTGOALS Patient goals and status
Patient alerts PATIENTALERTS

Active alerts that are categorized by patient

Count care plan instances grouped by care plan category, status CAREPLANSBYPROGRAMBYSTATUS ALL Patients 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 program ACTIVEPATIENTSBYPROGRAM Active care plans that are categorized by program
Active members by program ACTIVEMEMBERSBYPROGRAM Active members that are categorized by program
Active cases by owner ACTIVEADMCASESBYOWNERREPORT Active care management cases that are categorized by owner
Active case by case type ACTIVECMCASESBYCASETYPE Active care management cases that are categorized by case type
Active admissions by case type ACTIVEADMISSIONSBYCASETYPE Active 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 name Rule name Report description
Auth requests by status – Current year AUTHREQBYSTATUS Admission 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 reviews OPENDISCHARGEREVIEWS List of open discharge reviews
Open concurrent reviews OPENCONCURRENTREVIEWS List of open concurrent reviews
Discharge census on daily basis DISCHARGECENSUSFORUM List of discharged patients on a daily basis
Denied auth by auth type and reject reason code – Current year DENIEDAUTHREQ_CURRENTYEAR Denied authorizations that are categorized by the authorization type and the reject reason for the year
Denied admissions by reject reason code – Current year DENIEDAUTHREQAR_CURRENTYEAR Denied admissions that are categorized by the reject reason for the current year
Authorization Requests by Request Type & Status – Current Year AUTHREQBYREQUESTTYPE
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 Month AUTHREQBYREQUEST
TYPESTATUS_CURRENTMONTH
Authorization requests that are categorized by the request type and the status for the current month
Authorization Requests by Request Type - Current Year AUTHREQBYREQUEST
TYPE_CURRENTYEAR
Authorization requests that are categorized by the request type for the current year
Authorization Requests by Request Type - Current Month AUTHORIZATIONREQBYREQUEST
TYPE_CURRENTMONTH
Authorization requests that are categorized by the request type for the current month
Approved Admissions – No Notification APPROVEDADMISSIONS Approved admissions
Admission census on a daily basis ADMISSIONCENSUS
ONDAILYBASIS
Reported admissions and discharges for today
Admission census ADMISSIONCENSUS

Reported admissions that are being followed by the organization

Admission auth requests by status - Current year ADMISSIONAUTHREQ
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

Suggest Edit

Have a question? Get answers now.

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