Updated March 17, 2015

Pega Platform Review: "Pega for claims processing"

Verified User

Team Lead in Information Technology

Insurance Company, 1001-5000 employees

Score 7 out of 10

Vetted Review

Verified User

Software Version
PRPC 6.2

Modules Used
Healthcare Framework

Use Cases and Deployment Scope

We use Pega solutions to automate our claims processing systems and claims adjudication.

Pros and Cons

Pega has a variety of products to support claims processing; we use as a rules engine which helps us to drive our own business rules and make it as a complete rules processing system
It does provide health care frameworks, which comes up with pre-configured rules and decision making systems
The versioning and code repository is big plus with Pega as we do not depend on external versioning tool

The rule comparison is nice to have, but currently we don't have ability to compare one rule with a previous version to see the differences
To delete multiple steps in an activity in one single click
The documentation is not clear, sometimes it is missing key elements or has incorrect information

Return on Investment

Better customer service.

Alternatives Considered

Sharepoint LMS

How does Pegasystems stack up against SharePoint?

Likelihood to Recommend

The performance needs to be improved. The system is slow when it runs on limited hardware resources. Application development has a steep learning curve.