Ohio Medical Mutual Chooses Pegasystems

Pegasystems Inc., a provider of business process management (BPM) solutions and customer-centric software, today announced that Medical Mutual of Ohio will leverage Pega technology to modernize operations and improve quality of service. customer. Renowned for its technical innovation and commitment to customer service, Medical Mutual of Ohio is a mutual insurance company that processes nearly 100,000 claims per day for more than 1.6 million members.

Cleveland-based Medical Mutual has been included in the annual InformationWeek 500 list of the nation’s most innovative business technology users for the past three years. With Pega, he will now be able to improve the overall healthcare experience for his customers by improving several customer relationship management (CRM) and operational metrics, including first-call resolution rates, automated claims resolution, average call handling times and battery life. – the use of the services.

Pega’s Build for Change technology will help Medical Mutual deliver more consistent and meaningful customer service by guiding interactions through an intuitive user interface, accelerating and automating manual processes, and enforcing dynamic business policies through easy system rules. to manage. Pega was selected based on several criteria, including its ability to support:

• Integrated offices
• Complete contact history
• Knowledge of the contact context
• Strong reporting capabilities
• Knowledge management
• Support for additional platforms
• Commercial integration

The implementation – Medical Mutual will leverage Pega Customer Process Manager for Healthcare, Claims Repair and Claims Workstation+ solutions – is part of a strategic initiative that will drive enterprise-wide benefits. Pegasystems technology is used by 13 of the top 15 healthcare payers, more than 65% of the Blues Network, several leading provider organizations, and many of the top pharmacy benefit managers.

“At Medical Mutual, we pride ourselves on our commitment to providing exceptional customer value. We understand the importance of powerful technology to improve service and efficiency for all of our customers,” said Sue Tyler, Chief Experience Officer at Medical Mutual. “We are confident that Pega will help us implement our service philosophy, creating peace of mind for our customers through consistent and memorable customer experiences.”

“Medical Mutual of Ohio is embracing cutting-edge technology at a critical time when organizations must simultaneously deliver exceptional customer service and dramatically shift their cost curves,” said Keith Dayton, senior director, Healthcare Solutions for Pegasystems. “This customer-centric approach is transforming many healthcare organizations into more agile businesses so they can keep up with the rapid pace of change and new emerging priorities in healthcare.”

About Pegasystems
Pegasystems is a provider of customer-centric business process management and software that helps organizations retain customers, generate new business and improve productivity. Its Build for Change technology accelerates the delivery of critical business solutions by directly capturing business goals and eliminating manual programming.