List of Oracle Health Insurance Claims Administration Cloud Customers
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Since 2010, our global team of researchers has been studying Oracle Health Insurance Claims Administration Cloud 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 Oracle Health Insurance Claims Administration Cloud for Core Admin Processing System 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 Oracle Health Insurance Claims Administration Cloud for Core Admin Processing System include: Humana, a United States based Insurance organisation with 65680 employees and revenues of $117.76 billion, Point32Health, a United States based Insurance organisation with 4000 employees and revenues of $9.40 billion, Seguros SURA Colombia, a Colombia based Insurance organisation with 63292 employees and revenues of $7.37 billion and many others.
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| Logo | Customer | Industry | Empl. | Revenue | Country | Vendor | Application | Category | When | SI | Insight |
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Humana | Insurance | 65680 | $117.8B | United States | Oracle | Oracle Health Insurance Claims Administration Cloud | Core Admin Processing System | 2020 | n/a |
In 2020, Humana implemented Oracle Health Insurance Claims Administration Cloud as a Core Admin Processing System to modernize claims adjudication and enable real time processing across its Medicare Advantage book of business. The deployment uses a cloud based, modular approach, enabling Humana to focus initially on claims transformation while preserving the option to sequence additional administration components over time.
Humana completed initial configuration of the claims solution and is building interfaces to approximately 25 other systems, including third party repricers and enrollment, product, provider, and clinical applications. Oracle Health Insurance Claims Administration Cloud was configured to support real time adjudication workflows and to surface patient responsibility at point of care, with planned capabilities for member payment via Apple Pay, Samsung Pay, health savings accounts, or bank account.
The implementation targets operational domains in claims, membership, provider network, product administration, and clinical integration, with the explicit objective of scaling to process claims for millions of members in Humana’s Medicare Advantage plans. Integrations with third party repricers and upstream enrollment and product feeds enable straight through processing and exception routing consistent with modern claims automation patterns.
Governance and rollout followed a modular transformation plan, mapping the claims journey and prioritizing core administration capability delivery in 2020, followed by user acceptance testing and a planned early 2022 go live. Humana is also exploring AI assisted decisioning to expand adjudication intelligence and to support more nuanced member and provider outcomes while using the modular Core Admin Processing System architecture to limit scope and reduce cross domain reengineering.
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Point32Health | Insurance | 4000 | $9.4B | United States | Oracle | Oracle Health Insurance Claims Administration Cloud | Core Admin Processing System | 2020 | n/a |
In 2020, Point32Health deployed Oracle Health Insurance Claims Administration Cloud as a Core Admin Processing System to modernize claims adjudication and eligibility processing across its health plans. The deployment was delivered as a cloud, component-based solution built on a service-oriented architecture, enabling modular configuration and rules-based adjudication capabilities that align with enterprise Oracle investments.
Oracle Health Insurance Claims Administration Cloud was implemented with core modules for claims adjudication, componentized benefit administration, eligibility management, and utilization management support, leveraging Oracle Health Insurance Components for rule orchestration and auto-adjudication. The implementation emphasized configurable business rules and automation to increase auto-adjudication and to support rapid rule changes driven by payer policy and regulatory guidance.
Operationally the program was aligned with Point32Health business functions including claims operations, medical management, utilization review, and membership administration across multiple product lines including Medicare Advantage. The organization retained an Oracle-first approach given a large Oracle E-Business Suite footprint, and the new Cloud deployment was positioned to interoperate within that Oracle-centric technology stack while supporting remote operations that began in March 2020.
Governance and rollout followed a componentized, phased approach to enable incremental module activation rather than a single big box cutover, with centralized rule governance to manage adjudication and regulatory response. Outcomes reported by the organization include an increase in auto-adjudication to over 92 percent from 85 percent, reduced spending despite adding medical management programs, and faster, more accurate claims processing while maintaining customer experience during pandemic-driven operational changes.
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Seguros SURA Colombia | Insurance | 63292 | $7.4B | Colombia | Oracle | Oracle Health Insurance Claims Administration Cloud | Core Admin Processing System | 2023 | n/a |
In 2023, Seguros SURA Colombia implemented Oracle Health Insurance Claims Administration Cloud as a core element of its Core Admin Processing System modernization and cloud migration strategy. The deployment was executed on Oracle Cloud infrastructure and aligned with the company objective to centralize personal insurance operations and handle high volumes of health claims data securely and at scale.
The implementation focused on claims administration for health insurance, extending end to end into provider administration, benefits administration, customer care management, billing, underwriting support, and policy configuration via Oracle Insurance Policy Administration. Oracle Health Insurance Claims Administration Cloud was configured to support standard claims workflows, adjudication rules, provider network management, and benefit validation consistent with Core Admin Processing System functional patterns.
Integrations were centered on Oracle suite interoperability, with Oracle Insurance Policy Administration integrated into the operational stack and the Oracle Cloud architecture used to enable continuous application updates and product configuration. The pairing of Oracle Health Insurance Claims Administration Cloud with OIPA created a unified processing layer that supports policy to claim lifecycles and service orchestration for customer care and provider interactions.
Governance and operational enablement included centralized project oversight from SURA core teams, training programs to build cloud-native skills internally, and process adjustments to shift routine operational effort toward higher value activities. Project communications emphasized risk management, prediction, and prevention as operational priorities, and the CORE program management team guided rollout sequencing for personal insurance lines.
Explicit outcomes reported during the transition include service stability of 97.7 percent, reductions in operating times for selected processes, improved security and quality of insurance operations, and resolution of technological obsolescence in key support components. Oracle Health Insurance Claims Administration Cloud remains the transactional claims engine within Seguros SURA Colombia's Core Admin Processing System environment.
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Buyer Intent: Companies Evaluating Oracle Health Insurance Claims Administration Cloud
ARTW Buyer Intent uncovers actionable customer signals, identifying software buyers actively evaluating Oracle Health Insurance Claims Administration Cloud. Gain ongoing access to real-time prospects and uncover hidden opportunities. Companies Actively Evaluating Oracle Health Insurance Claims Administration Cloud for Core Admin Processing System include:
- 3i Group, a United Kingdom based Banking and Financial Services organization with 236 Employees
- The Cope Dungloe, a Ireland based Retail company with 100 Employees
- L.E.K. Consulting, a United States based Professional Services organization with 1900 Employees
Discover Software Buyers actively Evaluating Enterprise Applications
| Logo | Company | Industry | Employees | Revenue | Country | Evaluated | ||
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FAQ - APPS RUN THE WORLD Oracle Health Insurance Claims Administration Cloud Coverage
Oracle Health Insurance Claims Administration Cloud is a Core Admin Processing System solution from Oracle.
Companies worldwide use Oracle Health Insurance Claims Administration Cloud, from small firms to large enterprises across 21+ industries.
Organizations such as Humana, Point32Health and Seguros SURA Colombia are recorded users of
Oracle Health Insurance Claims Administration Cloud for Core Admin Processing System.
Companies using Oracle Health Insurance Claims Administration Cloud are most concentrated in Insurance, with adoption spanning over 21 industries.
Companies using Oracle Health Insurance Claims Administration Cloud are most concentrated in United States and Colombia, with adoption tracked across 195 countries worldwide. This global distribution highlights the popularity of Oracle Health Insurance Claims Administration Cloud across Americas, EMEA, and APAC.
Companies using Oracle Health Insurance Claims Administration Cloud range from small businesses with 0-100 employees - 0%, to mid-sized firms with 101-1,000 employees - 0%, large organizations with 1,001-10,000 employees - 33.33%, and global enterprises with 10,000+ employees - 66.67%.
Customers of Oracle Health Insurance Claims Administration Cloud include firms across all revenue levels — from $0-100M, to $101M-$1B, $1B-$10B, and $10B+ global corporations.
Contact APPS RUN THE WORLD to access the full verified Oracle Health Insurance Claims Administration Cloud customer database with detailed Firmographics such as industry, geography, revenue, and employee breakdowns as well as key decision makers in charge of Core Admin Processing System.