Is Knowledge Rules an approved Pegasystems partner?
Yes. Knowledge Rules has been an official Pegasystems partner since January 2006. As a Strategic Alliance partner, Pegasystems recognizes Knowledge Rules as being “experts in scoping, designing, building, deploying and managing Pegasystems-based implementations”. In fact 90% of KR’s staff is PRPC certified and approximately 35% are PegaWORKS certified making KR a world leader for PegaWORK’s maintenance and upgrade projects.
How big is Knowledge Rules?
Knowledge Rules is a multi-million dollar international privately held company.
Where is Knowledge Rules located?
Knowledge Rules is headquartered in Philadelphia, PA. We have additional offices in Beverly MA (near Boston) and Reading, Berkshire (in the UK). Our employees reside all across the continental United States and both Eastern and Western Europe. We service clients throughout the United States and the European Union.
Does Knowledge Rules have an offshore capability?
Knowledge Rules has many employees outside of the United States, including Eastern and Western Europe. In addition, we have worked with many of the leading offshore providers to deliver end-to-end solutions to clients that require offshore delivery integration.
Can I utilize KR’s services even though they are not on an approved vendor list? Absolutely. KR has Master Service Agreements (MSAs) with many of the world largest companies. We have found most organizations amendable to developing MSAs with a premium Pegasystems partner. In cases where this does not currently exist, KR has partner and pass through relationships with several major multi-national organizations which are on approved vendor lists at the world’s largest banks, insurance and healthcare organizations.
Why does Knowledge Rules often suggest working off-site?
We realize that many projects incur a 7% to 15% cost premium due to travel-related expenses. In today’s world of VPN access and secure connectively, our goal is to reduce this cost while offering premium service in the most efficient manner possible. We achieve this by identifying what tasks require an onsite presence and what can be performed remotely, and staffing and planning work accordingly. Regardless of location, Knowledge Rules staff is insured, and staff members continually meet current drug and background check standards.
What technologies does Knowledge Rules specialize in?
Knowledge Rules has broad technology expertise in:
- IBM MVS and VAX VMS legacy systems
- Unix and Microsoft platforms
- Cloud Computing
- Oracle DB, IBM DB2, and Microsoft SQL Server
- IBM MQ Series, SOAP, and HTTP Web Services (REST)
- Java and J2EE
- C++ and C#.net
- IBM Websphere, BEA WebLogic, Apache Tomcat
- Most major CTI products
Where does Knowledge Rules have expertise?
- Web Self-Service
- Underwriting
- Dispute Processing
- Fraud Detection / AML
- Credit Card Customer Service
- Credit Card Collections
- Credit Card Originations
- Loan Originations
- Money Transfer (SWIFT)
- Check Research and Adjustment
- Retail Banking Customer Service / CTI
- Mutual fund customer service
- Straight-through Processing
- Power Purge and Archive / Fiche
What types of healthcare companies have you worked with?
Knowledge Rules has worked with for profit and non-profit insurance and healthcare companies that work in both single and multi-state jurisdictions. We find that in every case, quality and timely service delivery is of paramount importance to our customers. Further, we have found that we can scale systems and costs to match customer size and complexity while still delivering sophisticated systems that increase automation, reduce errors and save time.
With which healthcare claims systems do you have experience with?
Our staff has worked on applications that interface with Perot Diamond, EDS TPS, RTMS, Metavance, and multiple in-house systems.
Do you have experience with member services and provider customer service systems?
KR has in-depth experience working with both business and IT to solve complex member and provider service issues to drive increased customer satisfaction (NCQA ratings) though higher first call resolutions and web self service. Our focus is to help organization deliver quality service while managing the cost of delivery.
Where does Knowledge Rules have application expertise in Healthcare?
- Individual and Group Enrollment Portal
- Provider Services Call Center
- Member Services Call Center
- HIPAA Compliance
- Managed Care and Healthcare Maintenance
- Claims Management Pre and Post Adjudication
- CMS / Medicare Medicaid Claims Compliance
- Workflow enabled transaction sets
Where does Knowledge Rules have industry expertise in Healthcare standards and mandates?
- MTM, NCQA and HEDIS standards
- Medicare part B application
- Pega/Claims system integration
What Pegasystems Frameworks have you had experience with in Healthcare?
- HPIF (Healthcare Payer Industry Foundation)
- Claims Repair
- Claims Workstation Plus
- CPM for Healthcare Member Services
- CPM for Healthcare Provider Services
- SPM (Sales Process Manager)
What types of insurance applications does KR have experience with?
KR has worked on a number of insurance applications ranging from marketing, policy management, and document management to streamline business process flows, enhance throughput and eliminate manual tasks. A sample of projects includes:
- Rules-based Marketing Campaign Management
- Policy Renewal Campaign, Small Business Workers comp on line quote and bind
- Document Workflow, AARP Service Automation and renewal
- Retirement Products and Structured Settlements, Policy Service Automation
- Single Product Variable Annuity (SPVA) Policy Management
- Center of Excellence
- Rules Harvesting to modernize legacy system applications
With what types of insurance products has KR worked?
KR has worked with Life, Auto, Retirement, Structured Settlements, and Property and Casualty products both domestically in the United States and in the EU.
What is a PRPC Certified System Architect?
A Certified System Architect is an individual that has met the training and testing requirements as established by Pegasystems’ Educational Services department. Over 90% of KR’s staff is certified on PRPC. But certification is not enough to ensure success in an implementation. You need to evaluate the experience and historical success in implementation of Pega BPM projects before choosing an implementation partner.
My PegaWORKS support staff has received Pega training but never took a certification tests, is that a problem for maintenance work?
Certification is a new offering from Pegasystems and is specific to PRPC. PegaWORKS customers often received training, but were never certified. Where the problem exist today is there is no training standard training offered by Pegasystems for PegaWORKS. For those needing support, maintenance and conversion services this can be a problem. Today, KR is unique in that 35% of its staff is certified in PegaWORKS and we can offer customer training and education services to meet your needs. Our certified PegaWORKS staff average more than 8 years experience in financial services, healthcare and insurance projects.
