HealthCare Member Portal

Overview:

Healthcare Member Portal Solution provides consumers with one-stop shopping for managing their health and wellness needs. It is a powerful platform for health insurance providers attempting to meet the growing self-education and self-service demands of an increasingly informed membership, while still controlling access to that information.

The solution leverages Oracle's WebCenter Interaction (WCI) to surface data from a variety of systems and deliver it to the user in a secure, personalized portal experience. Easily integrated with Universal Content Management (UCM) and other Fusion Middleware applications, as well as third-party systems, the Healthcare Member Portal Solution helps reduce both customer acquisition and member self-service costs.

Background:

Health care networks face increasing pressures from both consumers and the government. With more information than ever being available via the Internet, how do these networks ensure consumers and members are getting the right message to make important decisions about their families' health and wellness? And how do they remain confident that the information they provide to members is in compliance with HIPAA and other federal, state, and local policies?

The Healthcare Member Portal Solution is an ideal fit for health care networks concerned about maintaining privacy, security, and confidentiality. The portal framework provides for a secure, personalized experience to ensure that users only are exposed to the information to which they are entitled. Content management controls ensure that content is not displayed past its expiration date, without requiring IT intervention.

In addition, today's health care networks are dependent on costly call centers to handle the service needs of existing and prospective members. In many cases, even the most basic informational request requires customer service attention. The Member Portal Solution puts the control in the hands of the consumer to self-service his or her own needs, shifting call center focus to higher-value interactions. Both comparison-shopping consumers and existing members can now turn to the Member Portal for the information they seek, whether it be plan, coverage, or benefit data, or prevention-related content such as health and wellness news and tips. For enrolled members, the Member Portal provides an even richer experience, where they can find detailed, personalized information including claims, deductibles, and year-to-date balances, all in a secure setting.