Oracle Health Insurance Components

Oracle Health Insurance Claims Adjudication automates claim benefits adjudication by leveraging its adaptive, rules-driven architecture, powerful extensibility features, and restful API.

Oracle Health Insurance Claims Pricing enables healthcare payers to efficiently manage healthcare provider data, setup provider contract configuration, and automate claims pricing by leveraging its adaptive, rules driven architecture.

Oracle Health Insurance Product Definition enables healthcare payers to efficiently set up and manage claims adjudication products by leveraging its adaptive, rules-driven architecture.

Oracle Health Insurance Authorizations is a highly adaptive automated workflow component for processing healthcare authorizations.

Oracle Health Insurance Enterprise Policy Administration manages member contracts, tracks (retro-active) changes to member enrollment and uses that information to calculates the appropriate premium rates, both for individual and group policies.

Oracle Health Insurance Value-Based Payments gives payers the speed and flexibility they need to implement value-based payment models. Whether the payment model is well established or still evolving, Oracle’s solution can handle it. Payers can radically accelerate payments and improve efficiency by automating periodic calculations.

Oracle Insurance Gateway is a lightweight extension of Oracle Health Insurance Applications to facilitate speedy integration with inbuilt productized adapters.

Oracle Health Insurance Data Exchange Cloud Service simplifies and automates the exchange of operational data such as, enrollments and claims between payer’s core administration systems and their partners such as, employer groups, government authorities, and providers.