Health plan payers can transform their product approach with Pega Product Composer System for Healthcare and reduce time, cost, and risk for product development and operations. PCS has driven success and innovation of creating and maintaining health insurance products by providing three key transformation capabilities:

• Power to Simplify: Rapidly create and operationalize innovative products by easily configuring extensible benefits built to handle healthcare complexities including cost shares, penalties, limitations, exclusions, authorization requirements, networks (tiered and carve-outs), and claim- specific payment codes and instructions.

• Power to Change: Quickly implement regulatory updates and new product features through system-propagated changes that are intelligently automated across your product portfolio without maintaining separate and duplicative logic. With utilities such as data import and smart update, introduce new and change the old rapidly with a solid audit trail.

• Power to Engage: Define your brand and enhance customer engagement by seamlessly delivering context-sensitive product and benefit information across your preferred digital marketplace.

• Product Composer System features
• Case types in Pega Product Composer for Healthcare
• Roles, portals, and dashboard in Pega Product Composer for Healthcare
• Primary data entities
• Further reading