Line of Business
Line of Business (LOB) provides a way to organize Oracle Health Insurance Data Exchange Cloud Service components. These components are created to satisfy the data exchange needs of a specific health insurance market segment, such as Medicare or Commercial.
Oracle Health Insurance Data Exchange Cloud Service supports three ready-to-use system-defined LOB features:
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Medicare - Medicare Advantage (MA) and Prescription Drug Plan (PDP) health insurance market in the United States (US).
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Medicaid - US state-based health insurance programs for people meeting state-specific requirements based on their health and financial conditions.
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Commercial - Commercially available health insurance purchased by employers for their employees and individuals for themselves directly from payers or through health insurance exchanges in the US.
Each system-defined LOB has its own set of pre-defined transaction types for example, enrollment and associated processing flows, data formats, and templates for validation rules.
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Release 24.06.000 of Oracle Health Insurance Data Exchange Cloud Service supports the following on all three system-defined LOBs:
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These system-defined LOBs are disabled. You must create your own custom LOB according to your business needs and select any existing LOB as the base to inherit all the properties of that base LOB.