Health Insurance Simplified. Innovation Delivered.

The Oracle Health Insurance Management System enables insurers to simplify healthcare IT, achieve greater levels of operational efficiency, reduce costs, and adapt quickly to ongoing market and regulatory demands.

• 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 a secure, affordable cloud platform

Benefits

Transparent Member Experience

Improve the enrollment experience with faster premium calculations, better policy administration, quicker benefits adjudication, and accurate billing that can be deployed on-premises and in the cloud.

• Faster enrollments with digital ID cards
• Secure member privacy database
• Accurate billing with automated payments
• Visible end-to-end transactions
• Transparent member engagements

Faster Time to Market

Enable faster response to market and regulatory changes by eliminating the need for source code changes. Improve operational efficiency and bring new products to market faster through collaborative product development.

• Flexible, rules-driven configuration
• Update components and features more easily
• Create products quickly
• Turnkey for faster deployment
• Scalability to grow market share

Operational Efficiency

Lower health insurance claims management costs significantly by automating processes and increasing auto claims adjudication rates by using business rules-driven workflow.

• Automated Claims Pricing and Claims Adjudication
• Simplify claims operations with pre-built dashboards
• Quickly determine authorization approvals with configurable rules
• Efficiently manage provider data with healthcare claims management software
• Optimize Value-based payments

Modernizing Health Insurance Claims Management and Processing for Health Insurers

When it comes to health insurance claims management, few areas of the healthcare lifecycle deliver greater opportunity and risk. Learn how healthcare claims processing software is ripe for innovation.