PEGA

Industry - Financial Services

Region – US

Fraud Management Leading US Provider of Home Medical & Clinical Support – RPA-Optimized Customer Intake Process: Streamlining Patient Onboarding

Core takeaways

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Business challenge

Manual fraud management processes were slow and inefficient, often leading to delays in investigations. Communication breakdowns between fraud investigators and managers further hindered timely action, while the absence of real-time data made it difficult to track the progress of investigations, leading to increased risks and higher operational costs.

Solution overview

Eclatprime deployed a fraud management solution on Pega 8.8 that automatically created cases from fraud records received from third-party systems. The system enforced SLAs and used automated tagging to route cases to the appropriate fraud managers and investigation teams. Real-time dashboards provided visibility into each case, ensuring prompt communication and collaboration among team members.

Key success metrics