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Discover how Oracle is simplifying premium billing and claims processing.
Easily set up employer groups and enrollment rules, streamline the member enrollment process, and provide exceptional service with centralized member data.Explore Policy Administration (PDF)
Reduce operational costs and simplify administration of provider contracts with improved claims pricing and intelligent, automated claims adjudication.Explore Claims Administration (PDF)
Improve member satisfaction with timely, accurate, and transparent billing for all your plans: exchange, individual, group, ASO billing with stop loss, and government.Explore Revenue Management and Billing
Easily 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 a better quality of care.Explore Value-Based Payments (PDF)
“The vast majority of Humana’s claims are taking anywhere from four to five days.... The expectation with Oracle is that 80% of our claims are finalized within four hours of receipt.”
AVP of IT, Humana
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 Interoperability
Bring new products to market faster while complying with regulations by easily integrating with federal and private exchanges. Centralize rating data and eliminate anomalies between quoting engines and policy administration.Explore Enterprise Rating (PDF)
Create incentives for members to make improvements to their own health. Offer lifestyle coaching, rewards and loyalty programs, dashboards, and premium discounts and track their impact on member health.Explore Health and Wellness (PDF)
Build meaningful customer relationships with consistent, timely, and personalized interactions across all touchpoints.Explore Customer Experience Solutions
Healthcare regulations are constantly changing and healthcare payers are operating amid significant disruption and compliance challenges. COVID-19 is upending core operations as new mandates on data interoperability and transparency issued by the Centers for Medicare & Medicaid Services (CMS) put data competencies under a microscope.Read the complete post
Health insurance technology 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, an easy-to-manage health insurance platform for growth and scalability, and transparent member engagements.
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.