Oracle Health Accelerates Claims Processing with Automated Data Exchange between Healthcare Providers and Payers
Oracle has launched Oracle Health Clinical Data Exchange, a cloud-based solution built on Oracle Cloud Infrastructure (OCI) that streamlines medical claims processing through automated data exchange between healthcare providers and payers. This new system aims to replace manual transmission of medical records with a secure, centralized network, potentially reducing administrative time and costs, speeding up approval of patient clinical services, and accelerating claims and payment processing.
The solution addresses the current inefficiencies in the healthcare system, where about 70% of authorizations are done by phone or fax, and only 25% of documents related to reimbursement are shared digitally. Oracle Health Clinical Data Exchange offers enhanced data security, leveraging OCI's cybersecurity capabilities. Providers can control their data and audit which information was shared with payers, ensuring strong data governance and policy compliance.
Oracle ha lanciato Oracle Health Clinical Data Exchange, una soluzione basata su cloud costruita su Oracle Cloud Infrastructure (OCI) che semplifica il processo di gestione delle richieste mediche attraverso uno scambio di dati automatizzato tra fornitori di assistenza sanitaria e pagatori. Questo nuovo sistema mira a sostituire la trasmissione manuale delle cartelle cliniche con una rete sicura e centralizzata, potenzialmente riducendo il tempo e i costi amministrativi, accelerando l'approvazione dei servizi clinici per i pazienti e velocizzando il processo di richieste e pagamenti.
La soluzione affronta le attuali inefficienze nel sistema sanitario, dove circa il 70% delle autorizzazioni avviene tramite telefono o fax, e solo il 25% dei documenti relativi al rimborso è condiviso digitalmente. Oracle Health Clinical Data Exchange offre una maggiore sicurezza dei dati, sfruttando le capacità di cybersicurezza di OCI. I fornitori possono controllare i propri dati e verificare quali informazioni siano state condivise con i pagatori, garantendo una solida governance dei dati e conformità alle normative.
Oracle ha lanzado Oracle Health Clinical Data Exchange, una solución basada en la nube construida sobre Oracle Cloud Infrastructure (OCI) que simplifica el procesamiento de reclamaciones médicas mediante el intercambio automatizado de datos entre proveedores de atención médica y pagadores. Este nuevo sistema tiene como objetivo reemplazar la transmisión manual de registros médicos con una red segura y centralizada, lo que podría reducir el tiempo y los costos administrativos, acelerar la aprobación de los servicios clínicos para pacientes y acelerar el procesamiento de reclamaciones y pagos.
La solución aborda las ineficiencias actuales en el sistema de salud, donde aproximadamente el 70% de las autorizaciones se realizan por teléfono o fax, y solo el 25% de los documentos relacionados con reembolsos se comparten digitalmente. Oracle Health Clinical Data Exchange ofrece una mayor seguridad en los datos, aprovechando las capacidades de ciberseguridad de OCI. Los proveedores pueden controlar sus datos y auditar qué información se compartió con los pagadores, garantizando una sólida gobernanza de datos y cumplimiento normativo.
오라클은 Oracle Health Clinical Data Exchange를 출시했습니다. 이는 Oracle Cloud Infrastructure(OCI) 기반의 클라우드 솔루션으로, 의료 제공자와 지불자 간의 자동 데이터 교환을 통해 의료 청구 처리 과정을 간소화합니다. 이 새로운 시스템은 복잡한 의료 기록의 수동 전송을 안전하고 중앙 집중화된 네트워크로 대체하는 것을 목표로 하며, 행정 시간과 비용을 줄이고 환자의 임상 서비스 승인을 가속화하며 청구 및 지불 처리를 신속하게 할 수 있습니다.
이 솔루션은 현재 의료 시스템의 비효율성을 해결합니다. 현재 약 70%의 승인 절차가 전화 또는 팩스를 통해 이루어지고, 환급 관련 문서의 25%만 디지털로 공유됩니다. Oracle Health Clinical Data Exchange는 OCI의 사이버 보안 기능을 활용하여 데이터 보안을 강화합니다. 제공자는 데이터를 제어하고 지불자와 공유된 정보를 감사하여 강력한 데이터 거버넌스와 정책 준수를 보장할 수 있습니다.
Oracle a lancé Oracle Health Clinical Data Exchange, une solution cloud construite sur Oracle Cloud Infrastructure (OCI) qui rationalise le traitement des demandes médicales grâce à un échange de données automatisé entre les prestataires de soins de santé et les payeurs. Ce nouveau système vise à remplacer la transmission manuelle des dossiers médicaux par un réseau sécurisé et centralisé, ce qui pourrait réduire le temps et les coûts administratifs, accélérer l'approbation des services cliniques pour les patients et accélérer le traitement des demandes et des paiements.
La solution répond aux inefficacités actuelles du système de santé, où environ 70 % des autorisations sont effectuées par téléphone ou fax, et seulement 25 % des documents liés aux remboursements sont partagés numériquement. Oracle Health Clinical Data Exchange offre une sécurité des données améliorée, tirant parti des capacités de cybersécurité d'OCI. Les prestataires peuvent contrôler leurs données et auditer les informations partagées avec les payeurs, garantissant ainsi une gouvernance solide des données et le respect des politiques.
Oracle hat Oracle Health Clinical Data Exchange eingeführt, eine cloudbasierte Lösung, die auf der Oracle Cloud Infrastructure (OCI) basiert und die Verarbeitung von medizinischen Ansprüchen durch automatisierten Datenaustausch zwischen Gesundheitsdienstleistern und Kostenträgern vereinfacht. Dieses neue System zielt darauf ab, die manuelle Übertragung von medizinischen Akten durch ein sicheres, zentrales Netzwerk zu ersetzen, was potenziell Verwaltungszeiten und -kosten reduziert, die Genehmigung klinischer Dienstleistungen für Patienten beschleunigt und den Prozess von Ansprüchen und Zahlungen beschleunigt.
Die Lösung geht auf die aktuellen Ineffizienzen im Gesundheitswesen ein, wo etwa 70 % der Genehmigungen telefonisch oder per Fax erfolgen und nur 25 % der mit Rückerstattungen verbundenen Dokumente digital geteilt werden. Oracle Health Clinical Data Exchange bietet verbesserte Datensicherheit, indem es die Cybersecurity-Funktionen von OCI nutzt. Anbieter können ihre Daten kontrollieren und überprüfen, welche Informationen mit den Kostenträgern geteilt wurden, was eine starke Datenverwaltung und Compliance mit Richtlinien sicherstellt.
- Potential reduction in administrative time and costs for healthcare providers and payers
- Acceleration of claims and payment processing
- Improved efficiency in approval of patient clinical services
- Enhanced data security leveraging OCI's cybersecurity capabilities
- No additional charge for providers using Oracle Health's electronic health record (EHR) to onboard selected payers
- None.
Insights
Oracle's new Clinical Data Exchange solution addresses a critical pain point in healthcare administration. By automating the exchange of clinical data between providers and payers, it has the potential to significantly reduce the 70% of authorizations currently done by phone or fax. This could lead to substantial cost savings and efficiency gains across the healthcare system.
The move to a cloud-based, centralized network leveraging OCI's security capabilities is a strategic step. It not only modernizes an outdated process but also positions Oracle to capture a larger share of the healthcare IT market. The focus on data security and FHIR standard compliance will likely appeal to both providers and payers concerned about regulatory requirements.
For investors, this development signals Oracle's continued push into the lucrative healthcare sector. The potential for recurring revenue from this service, coupled with the possibility of upselling additional Oracle Health solutions, could contribute positively to Oracle's long-term growth in the healthcare vertical.
This product launch is strategically significant for Oracle's healthcare division. While specific revenue projections aren't provided, the healthcare claims processing market represents a substantial opportunity. The U.S. healthcare system spends an estimated
Oracle's solution targets this inefficiency directly, potentially capturing a slice of the savings generated. The offering of free onboarding for existing Oracle Health EHR customers is a smart move to drive adoption and could lead to increased customer retention and expansion within Oracle's healthcare ecosystem.
Investors should note that while initial impact on Oracle's financials may be , successful adoption could lead to a steady, high-margin revenue stream in the long term. This aligns well with Oracle's strategy to grow its cloud and SaaS offerings, which typically carry higher margins than traditional software licenses.
Oracle Health Clinical Data Exchange helps reduce costly and time-consuming manual processes, to deliver efficiency gains for payers and providers
"We're excited to begin using this new Oracle Health solution, which we expect to help us more easily and securely respond to payer data requests, and ultimately ease the current burden on our staff," said Kent Hoyos, vice president and CIO, Information Services, Pomona Valley Hospital Medical Center. "Automating the process will help speed approval of necessary patient clinical services as well as payment processing and shorten the wait time for our patients to receive the care they need."
Today, it is estimated that about
"Healthcare has long been plagued by costly, time-intensive, and antiquated claims processing that results in billions of unnecessary fees each year, and ultimately a strained relationship between providers and payers," said Seema Verma, executive vice president and general manager, Oracle Health and Life Sciences. "Oracle Health Clinical Data Exchange helps eliminate this burden by simplifying and automating tedious and inefficient manual processes. It frees up valuable provider time, helps payers get more accurate and complete clinical information, and accelerates care approvals and reimbursements."
Putting Patient Privacy and Data Security First
Powered by OCI, Oracle Health Clinical Data Exchange takes advantage of the same military-grade cybersecurity capabilities used to protect data at some of the largest and most sophisticated businesses, national defense agencies, and governments around the world. Providers control their data and can select what data to make accessible to their payer partners to maintain strong data governance. To support policy compliance, providers can audit selected clinical data with chosen payers to confirm exactly which data was received. Using Oracle Health Clinical Data Exchange, payers retrieve clinical data via FHIR queries or bulk processing in an industry-standard format familiar to payers. Oracle Health's centralized exchange enables payers and providers to establish a presence on the network once and share data with any other participant. No additional point-to-point connections are required.
Customers can sign up for Oracle Health Clinical Data Exchange by raising an SR in eService. Providers using Oracle Health's electronic health record (EHR) can easily onboard selected payers to Oracle Health Clinical Data Exchange at no additional charge.
Find out more about it at the Oracle Health Summit in
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FAQ
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