Oracle announced Oracle Health Insurance Components, to help healthcare payers.

 The integrated solution is henceforth available, with the goal, to provide an end-to-end solution to support the complete health insurance claims lifecycle, including pricing and benefits
adjudication, as well as the payment of providers through alternative, non-fee for service reimbursement methods.

 According to Oracle Healthcare payers can deploy Oracle Health Insurance Components individually in their service-oriented architecture (SOA) environments or pre-integrated as a complete, end-to-end processing backbone for payment processes.

Therefore Oracle Health Insurance Components include:

Oracle Health Insurance Claims Adjudication provides automated claims benefit adjudication to help payers accelerate processing, reduce costs and focus resources on more complex claims.

Oracle Health Insurance Claims Pricing helps payers to reduce operational costs by bundling claims into an episode of care and making a single payment to a provider, who then reimburses the other providers.

Oracle Health Insurance Product Definition enables payers to rapidly configure plans to meet unique client requirements.

Oracle Health Insurance Benefit Accumulator Management enables payers to avoid overpaying deductibles or benefit limits by providing a central source of truth for all member and family-level accumulators shared across multiple claims engines, and automatically tracks annual deductibles, out-of-pocket maximums and other limits.

Oracle Health Insurance Alternative Reimbursement helps payers to reduce operational overhead by providing automated payment generation.

Oracle Health Insurance Claims Analytics provides payers with prebuilt dashboards, reports and metrics that enable them to monitor performance analyze key performance indicators and compare them to benchmarks.

"Today, healthcare payers face common challenges, including rising treatment costs, ever-changing government regulations, new payment models, uncertainty around the impact of U.S. healthcare reform and a highly competitive marketplace. All of this is putting pressure on payers to change to keep pace with the market and reduce administrative and treatment costs in an effort to stay competitive. Oracle Health Insurance Components’ rules-driven, SOA architecture enables payers to adapt quickly to regulatory changes, respond to competitive threats, plan for the future and meet any opportunity or challenge the market delivers,” said Srini Venkatasanthanam, vice president, Insurance and Healthcare, Oracle Insurance.

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