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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 Technology?
Oracle wants to partner with you to help accelerate your health insurance 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. The Oracle Health Insurance Platform offers componentized and transparent applications for a better member experience.
HLTH: Navigating through the Data Interoperability Challenge
This year created a greater data challenge for health insurers and providers due to the impact of COVID-19, implementation of the 21st Century Cures Act, and the FHIR Data Interoperability standards.
Please join Rajeev Ronanki, Chief Digital Officer at Anthem, Vijay Venkatesan, Chief Analytics Officer at Horizon BCBSNJ, and Pam Fleury, Senior Director of Product Management at Oracle to learn more about best practices and ways to improve healthcare delivery and give patients greater visibility into their care journeys.
Why Medicare Advantage Plans Need to Double Down on Modernization
Understand how Oracle Health Insurance can help you drive efficient operations and enhance the customer experience in a move toward modernization.
Modernizing Claims Processing and Adjudication for Health Insurers
When it comes to claims management, few areas of the healthcare lifecycle deliver greater opportunity and risk. Learn why claims management and adjudication are ripe for health insurance innovation.
Simplifying Health Insurance Innovation
Health Insurance technology is essential to keep pace with the rapidly transforming industry. Discover how the Oracle Health Insurance Cloud Services offer rich functionality and flexibility for operational efficiency, an easy to manage health insurance platform for growth and scalability and transparent member engagements.
Oracle Health Insurance Solutions
Policy Administration
The Oracle Health Insurance Platform provides ease of case setup, enrollment, and member services for commercial and government business, all on a single platform.
Revenue Management and Billing
Oracle Health Insurance Technology allows you to accurately bill, collect, and scale your shared services for multiple lines of business.
Claims Administration
The Oracle Health Insurance Platform automates claim-benefit adjudication and supports straight-through processing, allowing health insurers to increase operational efficiency and claims payment accuracy.
Value Based Payments
Oracle Health Insurance Technology 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. The Oracle Health Insurance Platform uses a core administration engine and mobile health insurance technology 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 the 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)
