File Based Import
Oracle Health Insurance Claims Adjudication and Pricing supports the import of data from file for the following entities:
Claims also supports the import of data from file for the purpose of reprocessing claims.
The Process of File Based Imports
A file based import is a two-step process:
-
Upload the file using Data File Set Integration Point
-
Process the file contents by initiating the proper activity type using the Activity Integration Point. For example, use the Relation Import activity type to process the file based request for relation integration point.
Parameters
The parameters for the file import based activity are as follows:
-
Data File Set Code
This parameter indicates the data file set that needs to be processed.
The activity can be created only when the Indicator Locked on the data file set code is "N" otherwise an error ACT-VL-FIAT-001 is raised.
Once the activity picks up a data file set for processing (that is, starts a created activity), it places a lock on it by updating the indicator Locked to "Y". If the indicator Locked is already found to be "Y" then an error ACT-VL-FIAT-001 is raised. Activity must unlock the data file set in case if the processing completes with the errors.
-
Response Data File Set Code
The data file set code that should be used for the data file set of the response file. If not provided the system generates a UUID based value as data file set code.
Data File Validation
The first step in every data file import activity is to check whether the datafile that is provided through the parameters is valid for the specific data import. The following checks are executed:
-
Does the datafile exist (that is, is there a datafile in the datafile set)?
-
Is the datafile empty?
-
Is the datafile of the correct type for the import activity (that is, does it have the correct root element)?
Error Message
The file import based activity can result in the following messages:
Code | Sev | Message |
---|---|---|
ACT-VL-FIAT-001 |
Fatal |
Data file set {code} is locked and cannot be picked up for processing. |
ACT-VL-DAFI-001 |
Fatal |
No data file exists in datafile set {code}. |
ACT-VL-DAFI-002 |
Fatal |
Data file {code} is empty. |
ACT-VL-DAFI-003 |
Fatal |
Data file {code} is of incorrect type for this integration point. |
Example
This example gives a step-by-step explanation of how to load a data file with providers.
Not all Oracle Health Insurance components support providers. |
Step 1: Create Data File Set With a Data File
Request Message
The create data file set with a data file request has the following structure:
<dataFileSet code="ProviderImport_20141210_01" description ="Provider Import"> <dataFiles> <dataFile code="IndividualProviderFile1" descr="Individual Provider File 1" filepath="system1/tmp/Providers/1_1212121_v2.xml" -- For example, reference path of the external system, for information only. /> <dataFiles> </dataFileSet>
Response Message
<dataFileSet code="ProviderImport_20141210_01">
<links>
<link rel="self" type="application/vnd.ohi-xml" uri="http://[hostName]:[portNumber]/[api-context-root]pi/datafilesets/ProviderImport_20141210_01"/>
</links>
<dataFiles>
<dataFile code="IndividualProviderFile1">
<links>
<link rel="content" type="text/xml" uri="http://[hostName]:[portNumber]/[api-context-root]/datafilesets/ProviderImport_20141210_01/datafiles/IndividualProviderFile1/data"/>
</links>
</dataFile>
</dataFiles>
</dataFileSet>
Step 2: Upload Content
Use the URI
http://[hostName]:[portNumber]/[api-context-root]/datafilesets/ProviderImport_20141210_01/datafiles/IndividualProviderFile1/data
and upload the file having the structure as specified in Provider Integration point.
We recommend uploading files with sizes under 20 MB. Larger files impact the stability of the system. |
Request Message (JSON)
[
{
"code": "9200000060",
"flexCodeDefinitionCode": "US_PROVIDER",
"elementType": "organizationProvider",
"name": "Organization Provider 1",
"outputLanguageCode": "en",
"startDate": "2010-01-01",
"endDate": "2034-12-31"
}
]
Request Message (XML)
<organizationProviders>
<organizationProvider code="9200000060" endDate="2034-12-31" flexCodeDefinitionCode="US_PROVIDER" name="Organization Provider 1" outputLanguageCode="en" startDate="2010-01-01">
</organizationProvider>
</organizationProviders>
Response Message (XML)
The add content to data file request’s success response will have an appropriate HTTP status code in the header and the following structure:
<dataFileSet code="ProviderImport_20141210_01">
<links>
<link rel="self" type="application/vnd.ohi-xml" uri="http://[hostName]:[portNumber]/[api-context-root]/datafilesets/ProviderImport_20141210_01"/>
</links>
<dataFiles>
<dataFile code="IndividualProviderFile1">
<links>
<link rel="content" uri="http://[hostName]:[portNumber]/[api-context-root]/datafilesets/ProviderImport_20141210_01/datafiles/IndividualProviderFile1/data"/>
</links>
</dataFile>
</dataFiles>
</dataFileSet>
Step 3: Initiate the Provider Import Activity Using Create Activity
Activities
<activity level="GL" code="PROVIDER_IMPORT" description="Processed data file set 001.11">
<parameters>
<parameter name="dataFileSetCode" value="ProviderImport_20141210_01"/>
<parameter name="responseDataFileSetCode" value="responseProviderImport_20141210_01"/>
<parameter name="patch" value="true"/>
</parameters>
</activity>
Response Message
The start activity response has an appropriate HTTP status code in the header and the following structure:
<activity code="PROVIDER_IMPORT" status ="IN">
<links>
<link rel="action/startprocessing" type="application/vnd.ohi-xml" uri="{apiurl}/activities/12345/start"/>
</links>
</activity>
Step 4: Start Provider Import Activity
Use the http://[hostName]:[portNumber]/[api-context-root]`/activities/12345/start` to start the activity.
Step 5: Get Status
Use the URI /activities/12345
to get the status of the activity
Response Message
When the activity has not concluded the response structure is
<activity code="PROVIDER_IMPORT" status="IP"/>
When the activity has concluded with business errors the response structure is
<activity code="PROVIDER_IMPORT" status="CB">
<links>
<link rel="messages" uri="http://[hostName]:[portNumber]/[api-context-root]/activities/12345/messages"/>
<link rel="datafilesets" uri="http://[hostName]:[portNumber]/[api-context-root]/datafilesets/responseProviderImport_20141210_01/datafiles/67890/data"/>
</links>
</activity>
Step 6: Get Result Messages
Get more information about the result message by sending a request to URI /activities/12345/messages
Response Message
<activityMessages>
<resultMessages result="F" elementId="1234 A">
<resultMessage code ="REL-IP-PROV-031">
REL-IP-PROV-031: Country code AA is unknown
</resultMessage>
</resultMessages>
<resultMessages result="F" elementId="1235 B">
<resultMessage code ="REL-IP-PROV-031">
REL-IP-PROV-031: Country code AA is unknown
</resultMessage>
</resultMessages>
</activityMessages>
Step 7: Get Response File
Download the response file using "Get details of a data file" request from the data file integration point with URI datafilesets/responseProviderImport_20141210_01/datafiles/67890/data
File Details
<resultMessages result="F" elementId="1234 A">
<resultMessage code ="REL-IP-PROV-031">
REL-IP-PROV-031: Country code AA is unknown
</resultMessage>
</resultMessages>
<resultMessages result="F" elementId="1235 A">
<resultMessage code ="REL-IP-PROV-031">
REL-IP-PROV-031: Country code AA is unknown
</resultMessage>
</resultMessages>