Case Study: Harvard Pilgrim Health Care speeds claims processing with Oracle Exadata

Harvard Pilgrim Health Care Speeds Transactions for Approximately 1 Million Claims Monthly—Improves Customer Satisfaction and Delivers Peace of Mind

Harvard Pilgrim Health Care, a not-for-profit health plan serving more than 1.2 million members in New England, needed to efficiently process millions of medical claims while keeping costs low, improving transparency, and maintaining strong customer service amid healthcare reform. The company used Oracle Exadata with Oracle Health Insurance Components, including claims adjudication, to support its growing volume and operational demands.

Oracle Exadata helped Harvard Pilgrim implement a phased, service-oriented solution that automated claims processing and integrated with Oracle E-Business Suite. As a result, the insurer achieved a 90% to 92% automated claims-processing rate, processed about 1 million claims transactions each month, and in some cases sped up service and job processing by as much as 90%, improving accuracy, payment speed, and member satisfaction.

Harvard Pilgrim Health Care

Deborah Norton

CIO and Senior Vice President, IT and Operations