Enrollment Response Integration Point
This chapter describes the behavior of the enrollment interface. Oracle Health Insurance Authorizations initiates communication by sending out a request for enrollment information. The enrollment system sends a response back to Oracle Health Insurance Authorizations. The request query parameters contain the unique identifier for the serviced person or object, as well as the time-window for which enrollment information is required.
| The enrollment interface expects the payload to be in XML format. |
The response message can contain information about the following:
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The insurable entity type and code, the insurance type and the period in the request message
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Products
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List of policy products
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Parameters in the context of each product
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Dynamic fields and records in the context of each product
-
-
Messages
In a situation where the requested information is scattered across multiple components, the responsibility for the distribution of the request messages and the bundling of the response is assumed not to lie with Oracle Health Insurance Authorizations.
The identifiers in the response message must match the codes stored in Oracle Health Insurance Authorizations, for example the code that is used to identify a product in the response message will need to be the same code as set up in Oracle Health Insurance Authorizations.
Enrollment Request
The block below contains the request message in pseudo-code in case of a person enrollment;
GET http:{contextroot}/api/enrollment?insurableEntityType=<usageName>
&insurableEntityCode=<relationCode>&insuranceTypeCode=<insuranceTypeCode>
&startDate=<startDate>&endDate=<endDate>
In case of an object enrollment;
GET http:{contextroot}/api/enrollment?insurableEntityType=<usageName> &insurableEntityCode=&insuranceTypeCode=<insuranceTypeCode> &startDate=<startDate>&endDate=<endDate>
The attributes insurable entity type code and insurable entity code are the unique key associated with the serviced insurable entity (authorization requested for).
Oracle Health Insurance Authorizations determines the time period for which enrollment information is required. This is the start date and the end date of the authorization request.
The parameter insuranceTypeCode holds the insurance type code from the authorization’s authorization form. [1]
|
When Communicating to Policies the response structure that should be returned by Policies can be specified in the system properties. Refer Operations guide for more details. |
Enrollment Response
The block below contains the response message as expected by the system. Three consecutive decimal points indicate the possibility of multiple iterations. The response elements and their processing details are explained in the Enrollment Callout section of the Operations Guide.
<enrollment
insuranceTypeCode=""
startDate=""
endDate=""
>
<products>
<product
code=""
startDate=""
endDate=""
contractDate=""
>
<parameters>
<parameter
aliasCode=""
percentage=""
numberOfUnits=""
serviceDays=""
>
<parameterAmount
currency="">
{value}
</parameterAmount>
</parameter>
</parameters>
</product>
</products>
<messages>
<message
code=""
value0=""
(through)
value9=""
/>
</messages>
</enrollment>
The response message has a number of time valid elements. The time validity is expected to be bounded by the start and end date in the corresponding request message. In the event that the time validity of a product in the response exceeds the requested period, only the information valid in the requested period is taken into account by Oracle Health Insurance Authorizations.
In the event that there are no <product> elements available for the insurable entity for the requested time period, Oracle Health Insurance Authorizations expects HTTP Response code 204 (No Content).
Dynamic Fields and Records
A given implementation of Oracle Health Insurance Authorizations could have dynamic fields and dynamic records added to the policy product entity that need to be interfaced. For details on how external interfaces can provide values for dynamic fields and dynamic records in request messages and how they are handled by the Oracle Health Insurance application, refer to the concepts in the Configuration Guide.