Tackling the challenge of a new claims system, Part 1 | by Oscar Health | Oscar Tech | Medium

At Oscar, we took the bold step of developing an in-house claims system with a modern architecture and a tech stack wrapped around it that provides a completely new health insurance experience for our providers and members. Very few others have had the fortitude to do this, as it is a complex undertaking with far-reaching operational implications. Perhaps this is why so many payors are still using on-prem software to process claims. Oscar’s early claims vendor implemented their system in COBOL. So why invest in our own claims system? Years ago after exploring third party solutions, evaluating our business processes, and assessing our internal software development capabilities, we decided that building our own system was the only way to achieve a truly frictionless experience and high degree of operational flexibility/efficiency. Oscar Health is a high-tech healthcare company, not an insurance company with a tech team. We are working to disrupt U.S. healthcare for the benefit of our mem

At Oscar, we took the bold step of developing an in-house claims system with a modern architecture and a tech stack wrapped around it that provides a completely new health insurance experience for our providers and members. Very few others have had the fortitude to do this, as it is a complex undertaking with far-reaching operational implications. Perhaps this is why so many payors are still using on-prem software to process claims. Oscar’s early claims vendor implemented their system in COBOL. So why invest in our own claims system? Years ago after exploring third party solutions, evaluating