Pegasystems PEGACPLSA88V1 Question Answer
MyMealth Corporation wants to use the age of the claim to increase the urgency on the assignment so that claims processors work on the most urgent claims first. The claim assignment urgency increases by 1 each day the claim remains in an unresolved status. At any time. My Health has up to 10,000 claims in process. Claims in the PendingProcessing workbasket are subject to this calculation. The application updates the claim urgency daily before the work day begins. AM claims are processed within 30 days.
MyHealth also processes complaint cases from health plan members. Complaint cases use a service level agreement (SLA) to ensure the customer service representatives respond to complaints within 48 hours. All claims processors work in Los Angeles 9:00 AM-5:OQ PM PST.
Which approach satisfies the claim urgency requirement and provides the best experience for the claims processor?
Pegasystems PEGACPLSA88V1 Summary
- Vendor: Pegasystems
- Product: PEGACPLSA88V1
- Update on: Aug 2, 2025
- Questions: 238
