Efficient Billing and Pricing for Healthcare PayersIn an industry faced with technological disruption, legislative upheaval and changing customer expectations, healthcare payers are forced to be consumer-centric. Hence, healthcare payers too need to transform their business into digital health plans. Oracle’s best in class pricing and billing solution leverages the latest technologies, improves staff productivity and allows healthcare payers to provide better and faster services to their customers.

Digitally Connected CustomersHealth plan members want to be better informed, more engaged and empowered to make healthcare decisions. They demand instant, personalized and real time access to the tools, information and services about their their healthcare needs. Health plans must change to meet these new customer expectations.

A Digital Health Plan Enables Superior Customer ExperienceA healthcare payer committed to providing digital health plan begins by implementing a broad digitization strategy across the enterprise. This strategy includes building consumer-centric capabilities that meet customers’ expectations of a digital experience. It also involves launching innovative offerings to retain customers and build loyalty. Health plans must be able to provide accurate, timely access to billing data in order to accrue the benefits of “going digital”.

Better Informed

More Engaged

Empowered

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Oracle Revenue Management and Billing for Healthcare Payers

Enterprise Billing on a Single Platform Multiple lines of business – large group, small group, and individual (including exchange business) – may be managed on a single platform. Oracle Insurance Revenue Management and Billing supports fully-insured, self-insured, ASO business, as well as stop loss billing. And capability for manual and automatic invoicing.

Designed to Scale Designed to exceed the demands of the even the largest healthcare payers, Oracle Insurance Revenue Management and Billing is benchmarked to process premium bills for 56 million policies - three times the total number of individual policies in the US – in a single day.

“ “Rising Healthcare Cost and Medical Loss Ratio (MLR) requirements under the Affordable Care Act (ACA) create more pressure for Healthcare Payers to be more efficient, and control overhead costs.

Digital Processes Enable Greater Efficiencies Oracle Revenue Management and Billing lets payers eliminate manual processes through automation and integration. Using flexible and configurable, workflow-driven rules, premium billing, flexible pricing, automated payments and collection processes may be significantly streamlined for all types of payment plans.

Analytical Insight With analytical insight into operational performance trends, health plans can incorporate billing performance into management decision-making. The solution provides the ability to analyze and monitor performance of health plan benefits

HIPAA-Compliant SaaS Option Oracle offers a secure, HIPAA-compliant cloud option for Oracle Revenue Management and Billing. The cloud solution offers healthcare payers an infinite resource pool, saving investments in buying new hardware, software and maintenance. The solution offers high availability and performance of billing services for enterprise grade processes. This can lead to significant IT cost optimization helping in achieving economies of scale.

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Oracle Revenue Management and Billing Creates Differentiated Value

“ “The benefits that come from being a digital health plan are built on a foundation of operational efficiency in areas such as premium billing.

Why OracleOracle Revenue Management and Billing helps healthcare payers rapidly deliver new business practices and products with minimal disruption to existing systems and offers comprehensive pricing, billing, payment reconciliation and collections capabilities. Oracle helps enterprises deploy progressive and transformational approaches and solve healthcare needs. Leveraging smart technology that are intelligent and connected, Oracle solution enhance experience and affordability of healthcare services.

Build a Differentiated ValueOracle Revenue Management and Billing solution helps healthcare payers balance financial risks with ability to structure variable funding options. The solution provides flexibility in designing benefit plans and gaining cost control. Leveraging the variable pricing capabilities of the solution health care payers can easily build variable tax and fees. With Oracle’s solution healthcare payers can customize plans for the specific needs of each customer rather than employing a ‘one size fits all’ policy.

Enable Change Oracle Revenue Management and Billing solution helps healthcare payers transform into digital enterprises by ensuring an efficient operational foundation for their business. Healthcare payers can focus on launching new, consumer-centric digital capabilities with Oracle, providing the highest level of performance, flexibility, security, and scalability – a solid foundation for healthcare payers in the consumer-centric, digital world.

Oracle Revenue Management and Billing delivers a best-in-class enterprise billing platform – a rules-based system for billing, pricing, payment, and collections that increases revenue opportunities, reduces and control costs, provides transparency and improves customer service.

Premium Billing

Automated Payment

Flexible Pricing

High Fidelity Billing Insight

On-Premise or Cloud

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