List of In-House Insurance Claims Management Customers
Pleasanton, 94566 , FL,
United States
Since 2010, our global team of researchers has been studying In-House Insurance Claims Management customers around the world, aggregating massive amounts of data points that form the basis of our forecast assumptions and perhaps the rise and fall of certain vendors and their products on a quarterly basis.
Each quarter our research team identifies companies that have purchased In-House Insurance Claims Management for Insurance Claims Management from public (Press Releases, Customer References, Testimonials, Case Studies and Success Stories) and proprietary sources, including the customer size, industry, location, implementation status, partner involvement, LOB Key Stakeholders and related IT decision-makers contact details.
Companies using In-House Insurance Claims Management for Insurance Claims Management include: Oscar Health Insurance, a United States based Insurance organisation with 2400 employees and revenues of $2.20 billion, Blue Cross & Blue Shield of Wyoming, a United States based Insurance organisation with 220 employees and revenues of $100.0 million and many others.
Contact us if you need a completed and verified list of companies using In-House Insurance Claims Management, including the breakdown by industry (21 Verticals), Geography (Region, Country, State, City), Company Size (Revenue, Employees, Asset) and related IT Decision Makers, Key Stakeholders, business and technology executives responsible for the software purchases.
The In-House Insurance Claims Management customer wins are being incorporated in our Enterprise Applications Buyer Insight and Technographics Customer Database which has over 100 data fields that detail company usage of software systems and their digital transformation initiatives. Apps Run The World wants to become your No. 1 technographic data source!
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| Logo | Customer | Industry | Empl. | Revenue | Country | Vendor | Application | Category | When | SI | Insight |
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Blue Cross & Blue Shield of Wyoming | Insurance | 220 | $100M | United States | In-House Applications | In-House Insurance Claims Management | Insurance Claims Management | 2018 | n/a |
In 2018, Blue Cross & Blue Shield of Wyoming implemented the In-House Insurance Claims Management application. The In-House Insurance Claims Management platform functions as the organization’s Insurance Claims Management solution for dental provider interactions and core claims operations.
Deployment centered on a provider portal hosted at wy.ourdentalcoverage.com, branded for dentists as MyPatients'Benefits, providing secure access to patient records and benefit data. Functional modules include benefits and enrollment lookup, claims status tracking, allowance information, maximums and deductibles, and procedural history. The system includes a reimbursements module that presents reimbursement summaries and check level details linked to associated claims, and an online EFT management capability to receive payments directly to provider bank accounts, administered through the portal on behalf of Blue Cross & Blue Shield of Wyoming.
Claims intake and processing are supported by the Speed eClaim claims submission flow, which offers instant claim editing and resubmission and publishes explanation of benefits back to providers in near real time. The implementation weaves provider self service, claims adjudication workflows, and payment posting into a single web administered environment, enabling dental offices to submit electronic claims and manage remittance online while reducing reliance on paper, ink, and postage.
Operational coverage is focused on the insurer’s dental provider network and associated claims operations, provider relations, and service teams. Governance is implemented through portal based secure access controls and role based workflows for claim submission, editing, adjudication visibility, reimbursement posting, and EFT administration, with ongoing administration handled through the wy.ourdentalcoverage.com service layer.
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Oscar Health Insurance | Insurance | 2400 | $2.2B | United States | In-House Applications | In-House Insurance Claims Management | Insurance Claims Management | 2019 | n/a |
In 2019 Oscar Health Insurance implemented an In-House Insurance Claims Management application. The In-House Insurance Claims Management solution was developed in collaboration with Engineering and Product and launched to support payment integrity and claims processing workflows.
The implementation centered on core Insurance Claims Management capabilities including claims intake, automated adjudication pipelines, and an embedded payment integrity and fraud, waste and abuse detection layer developed by the Payment Integrity Research team. The Payment Integrity Research team of four data scientists managed model development and operationalization, instrumenting anomaly detection and prescriptive scoring into claim decision logic.
Operational coverage included claims operations, payment integrity, and analytics teams, with models and rules surfaced into adjudication and review queues to support investigator workflows. The program emphasized close coordination between product owners, engineers, and data science to align model outputs with claims rule engines and exceptions handling.
Governance incorporated cross functional reviews and staged rollout to production to validate model behavior and adjudication impacts before broader adoption. The narrative reflects an in house build and integration with Oscar Health Insurance claims operations rather than a third party implementation.
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