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Oracle Health Insurance Solutions
Simplifying your innovation journey and connecting the lives of the members you serve.
Why Oracle Health Insurance?
Oracle Health Insurance wants to partner with you to help accelerate your innovation journey. We offer an end-to-end core administrative platform for small and large health plans to modernize their systems at scale, introduce new products quickly, grow enrollments, and increase market share. Oracle offers componentized and transparent applications for a better member experience across their healthcare journey.
Webinar with AHIP—Healthcare Billing: COVID-19 Impacts, Industry Consolidation, and Modernization Agenda
Available On Demand
Over the past few years, several key issues have affected health insurance providers—from industry consolidation to the COVID-19 crisis. Join experts from Deloitte, RIA Advisory, and Oracle who will discuss how health insurance providers have reacted to the current crisis, impacts of industry consolidation between health insurance providers and PBM’s, and critical guidance on modernizing healthcare billing.
Simplifying Cloud Innovation
Healthcare innovation is essential to keep pace with the rapidly transforming industry. Discover how Oracle Health Insurance Cloud Services offer rich functionality and flexibility for operational efficiency, easy to manage systems for growth and scalability, and transparent member engagements.
Oracle Health Insurance Solutions
Policy Administration
Oracle provides ease of case setup, enrollment, and member services for commercial and government business, all on a single platform.
Revenue Management and Billing
Oracle allows you to accurately bill, collect, and scale your shared services for multiple lines of business.
Claims Administration
Oracle automates claim-benefit adjudication and supports straight-through processing, allowing health insurers to increase operational efficiency and claims payment accuracy.
Value Based Payments
Oracle offers a standalone component that runs alongside a core claims system, providing health insurers with the speed and flexibility they need to implement new reimbursement models.
Digital Health and Wellness
Oracle partners offer digital engagement tools that leverage information contained within Oracle products to create loyalty, and implement next- generation personal health and wellness programs to control medical costs.
Healthcare Interoperability
Oracle Healthcare Data Repository provides the foundation of a healthcare information exchange platform. This solution makes healthcare data more useful by supporting the integration and operation of a full spectrum of healthcare applications.
IDC Research: Trends in Digital Transformation and Member Engagements for Health Insurers
Oracle is integrating comprehensive core administrative processing and personalized proactive member health engagement in an ecosystem with partners such as dacadoo. Oracle’s solution uses a core administration engine and a mobile health platform in a cloud-based, closed-loop architecture to modernize operations, predictable risk, preventive health, and increased member engagement.
Customer Success Stories
Harvard Pilgrim HealthCare Increased Auto Adjudication Rate to 92 Percent and Reduced Claims Cost
Harvard Pilgrim HealthCare
In our new environment with Oracle, we're achieving 90-92 percent auto-adjudication. That means we don't need humans to touch those claims and means those claims are processed more accurately.Deborah Norton, CIO and SVP of IT and Operations, Harvard Pilgrim HealthCare
Humana discusses the advantages of implementing a modularized claims solution using Oracle Health Insurance
Humana
In the marketplace that was the only solution that allowed us to implement a claims solution without having to implement a totally integrated solution.Mike Wheatley, Associate Vice President, Humana
Defence Health leverages the flexibility of Oracle Health Insurance to bring products to market more quickly
Defence Health
Oracle was rated very highly for its modularization, configuration and flexibility.Joanne Kadlecik, COO, Defence Health Limited
Liberty Health Future-Proofs its Organization with Oracle Health Insurance
Liberty Health
We keep on reinvesting in Oracle because of the successes we’ve had in the past.Christo Groenewald Divisional Director, Health Business Enablement, Liberty Health
Flexible. Scalable. Transparent.
- Flexibility to manage business rules for different lines of business on a single platform
- Scalable for small and large health to create products quickly, grow enrollments, and increase market share
- Transparent for claim adjudications and claims processing for a better member experience
- All on athe cloud that is secure and affordable
Health Insurance Blogs
Innovative Solutions to Increase Operational Efficiency, Lower Administrative Costs, and Drive Scalability
Get an overview of Oracle’s transformative Core Administrative Processing Solutions (CAPS) for healthcare payers. (PDF)
Digital Transformation Piece by Piece: A Game Plan for the Unshakable Healthcare Payer.
Find out how health insurers can help providers improve care, reduce costs, and modernize claims payments. (2:26)
