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Enterprise Billing Solution With Oracle Revenue Management & Billing System

Enterprise Billing Solution With Oracle Revenue Management & Billing System. Oracle Open World 2014. July 23, 2014 (Draft). WellPoint – A Fortune 50 Company. With 2013 revenues of $71 billion and 47,500 employees, WellPoint is. One of the nation’s largest health benefits companies

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Enterprise Billing Solution With Oracle Revenue Management & Billing System

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  1. Enterprise Billing Solution WithOracle Revenue Management & Billing System Oracle Open World 2014 July 23, 2014 (Draft)

  2. WellPoint – A Fortune 50 Company • With 2013 revenues of $71 billion and 47,500 employees, WellPoint is • One of the nation’s largest health benefits companies • With more than 37 million members in its affiliated health plans and – • Nearly 69 million individuals served through its subsidiaries • Throughout the country as UniCare • In certain markets through its Amerigroup and CareMoresubsidiaries Which also serves customers:

  3. Broad Geographic Footprint and Membership Base Increasingly diverse customer base BC or BCBS plans in 14 states and Medicaid presence in 19 states Medicare 4% FEP 4% Individual 5% Medicaid 13% ` National Accounts 19% 37.3million Local Group 41% BlueCard 14% BC or BCBS licensed plans (6) Medicaid presence (11) BC or BCBS licensed plans + Medicaid presence (8)

  4. Evolution of WellPoint, Inc. Anthem, Inc. WellPoint Health Networks 1992 to 2004 2004 to Present Empire HealthChoice Assurance, Inc.

  5. Our Culture Purpose Statement Together, we are transforming health care with trusted and caring solutions Vision To be America’s valued health partner We deliver results. We strive for excellence. We make a difference for our customers. We make a difference in people’s lives. We treat our customers the way we want to be treated. We engage and listenwith empathy. We provide simple solutions. We use clear language. We make it easy for customers even when it’s hard. We support creativity and risk-taking. We look to the future while acting in the present. We challenge the status quo. We do the right thing. We are transparent in words and deeds. We keep our commitments.

  6. Our Challenges

  7. Benefits of Consolidation With Oracle’s RMB • Consolidated Platform • One billing platform for all administrative service only groups (ASO) across different regions and LOBs • Stream lining and standardizing processesacross the organization • Robust and flexible architecture to support changing business needs • Enhanced Business Values • Automated and flexible billing schedules, complex pricing, collections processes and billing formats • Increased automated payments through ACH, increased billing andcollections frequencies • Improved asset andcash flow management • Rich User Experience • Billing data and account information exposed via web portal • Self service capabilities for clients to create and update their own profiles • Multiple communication channels between WellPoint and clients to improve users’ experience ...We have got to be more efficient, more flexible and easier to do business with...

  8. Solution Overview • Involves rich set of interfaces with their own technologies, systems, processes and stakeholders • Requires additional build out to compliment RMB capabilities • Minimizes changes and impacts to upstream and downstream systems • Maximizes the values of existing technologies and processes • Significant focus on balancing and control of financial information, membership details and client data • Leverages Oracle Exadata hardware and architecture for production and test environments Membership Members Service Providers Claims Client Structure ASO/SL Billing Rule Configuration (RMB) Information Hub Billing Engine (RMB) Product & Rates Content Management Group Admin Interfaces (batch/real-time) Internal Staffs Data Store Reporting (Business Object) Finance Brokers Regulatory Agencies

  9. Solution Overview – Cont’d

  10. Implementation Approach

  11. Thank You Q & A

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