Healthcare and Social Security

Streamlining operations to help provide a high quality of care and improved services to those who have served their country.

Government social services, also known as social welfare programs, are charged with protecting and aiding citizens and constituents – whether that’s combatting poverty and disease or providing support for people with disabilities and facing economic or physical hardships. These services vary, yet typically include both cash and food assistance programs. While government healthcare models also vary globally, they are typically concerned with aiding society during emergencies (and at other times) to ensure citizens have proper healthcare and support for their well-being.

A US agency responsible for administering programs in support of veterans, their families and survivors, wanted to improve its service and ensure those who had served their country could receive the absolute best care possible. That meant ensuring a timely and accurate payment of $14 billion worth of goods and services to its medical facilities.

Implementing Pega Case Management functionality, the agency created an Invoice Payment and Processing System (IPPS). IPPS is a unified, online invoice certification system that processes all payments on behalf of medical facilities nationwide, including the purchase of hospital equipment, from pace makers and hospital beds to facility maintenance services.

With IPPS, the agency has been able to streamline operations and slash invoice processing costs by 33% – allowing it to redistribute staff to other mission critical areas across the organization, and in turn ensuring that agents spend time with the veterans who need it.

Payment accuracy has improved to nearly 100% – ensuring there are no overpayments or inaccuracies, not only saving tens of millions of dollars – but also, in turn, retaining the best vendors to ensure the best veteran care through access to the best suppliers and services.

That’s not all. By unifying all payment processing, the agency was able to replace legacy applications and improve the system’s efficiency and flexibility. Multiple siloed systems were united through automation, leading to significant time savings and improved employee productivity.

Delivering outstanding customer service is also a critical piece of veteran care. By uniting four call centers and ensuring one single point of contact for vendors the agency had a more complete view including customer history. This allowed for better, and faster, resolution of veteran problems.

The result? Happy citizens by way of improved care and access to serves, and an empowered and efficient government.

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