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As a healthcare insurer/payer, you know that processing member data and claims is the most essential business process. In order to process the huge volumes on time and without errors, you require automated support. This support must be reliable if you want to keep your customers satisfied. Moreover, it must not obstruct you in realizing your strategy.
Oracle Health Insurance BackOffice gives you the flexibility to use uniform processing-policies and claims-to provide consumers with tailor-made products, comply with changing laws and regulations, and make detailed procurement agreements with healthcare providers. It is important that healthcare costs can be controlled so that you avoid paying out claims by mistake. The rules that you lay down for coverage for a product and for healthcare agreements are automatically checked in the claims process.
The administrative processing costs are low because they are based on "straight-through processing". Manual processing is required only for transactions that are not processed digitally because the result of the processing does not meet the specified criteria. The financial result of the processing procedures is contained in the Financial Interface of Oracle Health Insurance BackOffice.
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