Achieve faster enrollments and accurate billing with our comprehensive SaaS solution for policy administration, revenue management, and billing. Stay competitive with frictionless onboarding, efficient member management, and flexible billing options.
Discover how the Oracle Health Insurance solution simplifies claims processing and premium billing
This end-to-end core administrative platform for small and large health plans enables them to modernize their systems at scale, introduce new products quickly, grow enrollments, and increase market share.
Cruise Through the Health Plan Enrollment and Billing Journey
Learn how our solution helps payers surmount persistent data, performance, compliance, and security challenges to enable frictionless onboarding, a central golden member record, effective member management, and more accurate, efficient pricing and billing.
Value-Based Payments: Scaling Up for Success
Oracle Health Insurance Value-Based Payments Cloud Service streamlines payments, helping enhance efficiency and patient outcomes. Payers benefit from reduced errors and manual tasks, supported by Oracle’s vital role in optimizing operational efficiency and payment model adaptation.
Fireside chat: Modernizing Defense Health’s operations.
Easily set up employer groups and enrollment rules, streamline the member enrollment process, and provide exceptional customer service with centralized member data.
Explore Policy Administration (PDF)Reduce operational costs and simplify claims administration with improved claims pricing and intelligent, automated claims adjudication. Efficiently manage provider contracts, getting complete traceability of your provider contract configurations and corresponding claims pricing.
Explore Claims Administration (PDF)Improve member satisfaction with timely, accurate, and transparent billing for all your plans—exchange, individual, group, administrative services only (ASO) billing with stop-loss, and government.
Explore Revenue Management and BillingEasily administer and automate payment contract models such as accountable care, capitation, and bundled payments. Focus your offerings on value, outcomes, and risk sharing so your members can benefit from lower costs and better quality of care.
Explore Value-Based Payments (PDF)Reduce costs and improve patient outcomes by consolidating healthcare data—including discrete clinical data, clinical documents, and patient summary records—in a single repository.
Explore Healthcare Data ManagementRapidly deploy your most important applications in the cloud with the security and data protection that health insurers require. Whether you are running legacy workloads or new cloud native applications, get exceptional performance and scalability with consistent support for regulatory compliance.
Explore Oracle Cloud InfrastructureData Exchange Cloud Service is built on AI-powered Oracle Cloud Infrastructure and designed to meet the specific integration needs and challenges of the health insurance industry. With this service, you get a secure, scalable, and future-proof data exchange platform powered by Oracle Autonomous Database and the latest Oracle technology stack.
Explore Data Exchange Cloud Service (PDF)Bring innovative or complex health insurance products to market faster by centralizing rating data. Eliminate anomalies between quoting engines and policy administration systems. Comply with regulations by easily integrating with federal, state, and private healthcare exchanges.
Explore Enterprise Rating (PDF)“You need to have a finance system that gives you the flexibility and access to information required to support the kinds of innovations we are investing in as a health plan and partner to hospitals and independent systems. We get that with Oracle.”
Senior Vice President and Chief Financial Officer, Blue Shield of California
Simplify your financial processes and gain better control on data quality and consistency through a unified data model and common analytics. Mitigate risk by getting better insights from policy and claims data through machine-learning–based anomaly detection.
Explore Insurance ERPDeploy Oracle's secure public cloud and Oracle Healthcare Foundation to support the Quadruple Aim model of cost, population health, patient experience, and clinician satisfaction. Predict risk in patient populations and uncover the factors affecting per capita cost while keeping clinical data secure.
Explore Oracle Analytics CloudEasily onboard new members and help them find answers about their coverage, benefits, and claims through the channels they prefer. Deliver instant access to answers, personalized advice, and tailored content. Provide 24/7 guidance with AI-enabled virtual assistants.
Explore Customer Experience SolutionsDeploy one system to connect your human resource processes, from hire to retire. Build a people strategy to stay ahead of changing markets and empower your teams to be successful at their jobs.
Explore HCM for Financial ServicesJoin Oracle experts and a featured IDC analyst as they delve into the healthcare payer and provider data exchanges and discuss the evolution of value-based care and payments in this AHIP webinar.
Learn more about the greater data challenge for health insurers and providers due to the implementation of the 21st Century Cures Act and the FHIR Data Interoperability standards.