Healthcare capabilities
This section provides an overview of Pega Customer Service for Healthcare and shows
the application stack. Pega Customer Service for Healthcare helps reduce service costs and improve customer
satisfaction through a process-driven approach that resolves customer issues with context,
immediacy, and relevance at the initial point-of-contact. Enables healthcare organizations to service consumers of healthcare
services, such as health plan members Enables healthcare organizations to service medical providers, such as
physicians, practice staff, and healthcare system personnel Provides healthcare organizations with capabilities for patient care
and engagement Built on the Pega Platform, Pega Customer Service for Healthcare automates common service requests
through intent-driven processing and anticipates customer and operator needs so that customer
service representatives (CSRs) have the necessary tools to deliver personalized and responsive
service. The application delivers new value from healthcare organizations’ back-end data and
processing silos, provides agility to meet changing business requirements, and facilitates
compliance with internal and external regulations.
Pega Customer Service for Healthcare is built on the Pega Customer Service and Pega Foundation
for Healthcare applications. It includes multiple components; some components are optional.
The healthcare data model and healthcare service processes are provided for you in the
Pega Customer Service for Healthcare application. The Pega Customer Service for Healthcare media includes Pega Sales Automation for
Healthcare because they are designed to complement each other through the use of common case
types and a unified data model. Each application requires a separate license in order to use it.
Pega Care Management is built on Pega Customer Service for Healthcare. For more information
about the capabilities that are available by implementing the two applications together, see the
Pega Care Management product page. If you are using Pega Customer Decision Hub and Pega Care Management, install those applications separately. Pega Customer Service for Healthcare can be used in different types of healthcare
contact centers. As part of installation, you can optionally install the sample application
that includes operators and access groups. You use them to access the sample application and
review the application's capabilities, copy into your application, or extend to meet your
business needs. The sample application includes operators and access groups for the following types of
healthcare contact centers: Pega Customer Service for Healthcare
Pega Customer Service for Healthcare application stack
Pega Customer Service for Healthcare sample operators and access groups
Member Services, Patient Services, and Provider Services
Name Description Default access group Default portal CSHCSysAdmin Systems administrator operator CSHC:SysAdmin Dev Studio CSHCManager Contact center manager operator CSHC:MGR Interaction Portal CSHCCSR Contact center representative operator CSHC:CSR Interaction Portal CSHCAppStudioAdmin Systems administrator operator CSHCAuthor App Studio CSHCMedicare SysAdmin Systems administrator operator CSHC:MedicareSysAdmin Dev Studio CSHCMedicare Mgr Contact center manager operator CSHC:MedicareMGR Interaction portal CSHCMedicareCSR Contact center representative operator CSHC:MedicareCSR Interaction portal CSHCMedicareAppStudioAdmin Systems administrator operator CSHCMedicareAuthor Dev Studio
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