Oscar Health quietly built its own claims processor to simplify physician payments

Health insurance startup Oscar Health said it finally has the claims processing infrastructure to provide clearer physician payments — and turn a profit, according to CNBC.

The insurer has built an infrastructure for provider directories and claims processing from the ground up. Oscar's co-founder and CEO, Mario Schlosser, said the in-house system will allow the insurer to simplify the billing process. The ability to pay physicians for practicing during evenings and weekends, and provide transparent procedure costs for members, are some of the advantages Oscar said its system provides.

The company said the culmination of better technology, narrow networks and member engagement will help turn around its losses.

Oscar lost $92.4 million in 2015 and $124 million-plus in 2016. That year, Oscar hiked premiums and shifted to narrower provider networks, which curbed losses in 2017. Oscar announced expansions into four new markets in mid-May, and intends to add four to five new cities each year, according to the report.

"Before you know it, we'll be profitable," Oscar CFO Brian West recently told CNBC after Oscar raised $165 million in a funding round in March, which upped its valuation to more than $3 billion. "It's around the corner."

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