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Oracle Health Insurance Solutions

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Overview

Oracle Health Insurance is a modern enterprise solution that enables payers to simplify healthcare IT, achieve greater levels of operational efficiency, reduce costs, and adapt quickly to ongoing market and regulatory demands. Oracle Health Insurance brings healthcare technology that allows payers to deliver straight-through processing of claims, policies and authorizations. Health insurers can decide whether they want to implement individual components or as a full suite, either on-premise or on the cloud.

Key Features

  • Highly flexible, rules-driven configuration model
  • Extensive provider admin and provider contract functionality
  • Straight through claims processing
  • Extensible data model with the possibility to tailor the standard processing logic
  • Out of the box analytics dashboards
  • Standard web services to connect to neighboring applications
  • Integrated configuration migration functionality
  • Multilanguage and multicurrency functionality to comply with localization requirements

Key Benefits

  • Reduce total cost of ownership with HIPAA-compliant solutions for enrollment, premium calculation, claims processing, capitation, benefits adjudication and billing that can be deployed on premise and in the cloud
  • Lower administrative costs significantly by automating processes and increasing auto adjudication rates by using business rules-driven workflow
  • 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
  • Support compliance with evolving regulatory demands through a highly flexible, extensible and open architecture
  • Reduce complexity, risk and cost with Oracle's proven health insurance solutions

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Product/Service details

SOLUTION OR SERVICE TYPE
Health Claims and Case Management Systems (Medical, LTC, Disability), Policy Administration and Servicing (PAS) Systems - Health / Major Medical
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