Oracle Health Insurance Claims Management

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. Features: * 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. Features: * 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. Features: * 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

360-Degree View: Gain a comprehensive view of claims and operations by eliminating data silos and utilizing prebuilt, configurable dashboards. Access powerful reporting and analytics capabilities through an intuitive interface. Features: * Easy-to-use, prebuilt dashboards * Improve decision-making with real-time insights * Reduce administrative costs and optimize business processes * Centralized data repository with data integration * Easily configurable reports and analytics

Cost Savings: Reduce administrative costs, improve the customer experience, and deliver value-based care with a single, scalable platform that automates complex business processes, including claims processing, billing, and policy administration. Features: * Automated Business Processes * Streamlined Policy Administration and Improved Customer Service * Claims Processing Simplification with Pre-built integrations * Improve Provider Engagement with Health Insurance Claim Management system * Automated billing and payments

Digital Engagement: Digitize your member and provider engagement processes, improve member satisfaction, and create efficiencies that enable your organization to provide better, more affordable care. Features: * Digital Member and Provider Portals * Secure, mobile-enabled access to information * Automated correspondence and notifications * Empower Members with Digital ID Cards * Empower Providers with Data Access

Scalability: Scale for small and large health plans quickly to create products quickly, grow enrollments, and increase market share on a secure, affordable cloud platform. Benefit from flexible deployment options. Features: * Scale on a secure cloud platform * Quick product creation with pre-built templates * Flexible deployment – on-premise, cloud, or hybrid * Automated enrollment processes * Secure and reliable platform with disaster recovery options