| Healthcare Patterns | Application | Description | Version |
|---|
| Extending the Prior Authorization request Microjourney | Care Management | Identify and add extension points in the Prior Authorization request Microjourney | 8.5 |
| Setting the application perspective to payer or provider in Care Management | Care Management | Customizing data collection for various healthcare uses. | 8.5 |
| Extend the Add Child Dependent Microjourney | Customer Service | Learn how to extend the Add Child Dependent Microjourney | 8.5 |
| Extending the View Benefits Microjourney | Customer Service | Learn how to extend View Benefits Microjourney. | 8.5 |
| Pre-emptively notify customers about benefit issues | Customer Service | Learn how to use data flows | 8.5 |
| Using the Member data type in Pega Customer Service for Healthcare | Customer Service | Learn how you can capture consumer data in Pega Customer Service for Healthcare with the Member data type | 8.5 |
| Create a Custom Code Group in Pega Foundation for Healthcare | Foundation for Healthcare | Learn how to create code groups to support multi-faceted transactions in Pega Foundation for Healthcare. | 8.1 |
| Create a Post-Service Appeal in Pega Foundation for Healthcare’s Appeals and Grievances Manager Layer | Foundation for Healthcare | Learn how to create and handle appeals claims in Pega Foundation for Healthcare’s Appeals and Grievances manager layer. | 8.1 |
| Extending portals to enhance the claims processing experience | Other Industry-Specific Application | Concepts and considerations for extending claim processing portals. | 8.5 |
| Optimizing performance tuning data processing through retrieval and indexing | Other Industry-Specific Application | Guidelines on retrieving and indexing application data for faster processing | 8.5 |
| Configuring and extending stages, statuses, and workbaskets | Product Composer for Healthcare | Design inputs and details for configuring and extending stages, statuses, and workbaskets | 8.5 |
| Extending coverage data to leverage inheritance | Product Composer for Healthcare | Details about how the coverage data can be extended in PCS | 8.5 |
| Extracting data for reporting, QC, and downstream integration | Product Composer for Healthcare | Design inputs for extracting data for reporting, QC, and downstream integration | 8.5 |
| Implementing the SBC Feature | Product Composer for Healthcare | Implementing the Summary of Benefits and coverage (SBC) feature | 8.5 |
| Implementing versioning | Product Composer for Healthcare | Design inputs while implementing versioning in PCS | 8.5 |
| Search configuration and extension | Product Composer for Healthcare | Search configuration and extension | 8.5 |
| Creating and extending sequences to customize adjudication | Smart Claims Engine | Description and use of sequences in the Smart Claims Engine application. | 8.5 |
| Creating guided event flows using UI patterns | Smart Claims Engine | Learning about the Smart Claims Engine (SCE) guided event resolution flow | 8.5 |
| Creating new event codes for claim adjudication | Smart Claims Engine | Describes the pattern behind adding new event codes | 8.5 |
| Creating new, extending existing and bypassing modules | Smart Claims Engine | Optimizing modules for the Smart Claims Engine for Healthcare | 8.5 |
| Creating orchestrations to control claim processing | Smart Claims Engine | Describes the role of orchestrations and how they can be used for complex processing scenarios | 8.5 |
| Utilizing action codes to manage SCE processing | Smart Claims Engine | Guidelines for extending processing flows by using action codes | 8.5 |
