Oracle Health introduced tools aimed at easing administrative healthcare burdens and costs.
The company’s new artificial intelligence-powered offerings are designed to simplify and lower the cost of processes such as prior authorizations, medical coding, claims processing and determining eligibility, according to a Thursday (Sept. 11) press release.
“Oracle Health is working to solve long-standing problems in healthcare with AI-powered solutions that simplify transactions between payers and providers,” Seema Verma, executive vice president and general manager, Oracle Health and Life Sciences, said in the release. “Our offerings can help minimize administrative complexity and waste to improve accuracy and reduce costs for both parties. With these capabilities, providers can better navigate payer-specific coverage, medical necessity and billing rules while enabling payers to lower administrative workloads by receiving more accurate claims from the start.”
Annual administrative costs tied to healthcare billing and insurance are estimated at roughly $200 billion, the release said. That figure continues to rise, largely due to the complexity of medical and financial processing rules and evolving payment models. The rules and models are time-consuming and inefficient for providers to follow and adopt, so they use manual processes, which make them prone to errors.
The PYMNTS Intelligence report “Healthcare Payments Need Modernization to Drive Financial Health” found that healthcare’s lingering reliance on manual payment systems is proving to be a bottleneck for its financial health and operational efficiency.
The worldwide market for healthcare digital payments is forecast to increase at a compound annual growth rate of 19% between 2024 and 2030, indicating a shift and market opportunity for digital solutions, per the report.
The report also explored how these outdated systems strain revenues and create inefficiencies, contrasting the sector’s slower adoption with other industries that have embraced digital payment tools.
“On the patient side, the benefits are equally compelling,” PYMNTS wrote in June. “Digital transactions offer hassle-free experiences, which are a driver for patient satisfaction and, ultimately, patient retention.”
The research found that 67% of executives and decision-makers in healthcare payer organizations said that their firms’ manual payment platforms were actively hindering efficiency. In addition, 74% said these platforms put their organizations at greater risk for regulatory fines and penalties.