Relations: Introduction
In Oracle Health Insurance, a relation represents a single person or a single organization. The application uses person records for members, policyholders, contact persons, and other roles represented by a natural person. It uses organization records for employers, reinsurers, and other roles represented by a legal entity.
Persons and organizations share many attributes and features, because they can fulfill the same role. For example, a beneficiary on a claim can be a person or an organization.
This topic describes the shared attributes of relations and the attributes that apply only to persons. For detailed field descriptions, constraints, and configuration reference data see Relations.
Shared Attributes
Identifiers
Every relation has a unique code as its primary assigned identifier. This identifier is either system generated or assigned by an external source upon creating the relation record.
In addition, you can attach an unlimited number of alternative identifiers to the relation. The application uses these alternative identifiers to recognize the relation with context of the intake process for claims and enrollment updates, when it fails to recognize the relation by its primary identifier.
Person Only Attributes
Access Control
Relations are subject to several access controls. Relations are subject to access controls. Some controls restrict access to the entire relation, others restrict access to specific details.
All relations have access controls on their line of business and on their alternative identifiers. To see a relation that belongs to a certain line of business, you require access to that specific line of business. This access control protects the complete relation record and all its details.
To see a relation’s alternative identifiers, you require access per identifier type. For example, to see a person’s social security number, you require access to the identifier type for social security numbers. This access control only protects the identifier values; other attributes on the relation record are not protected by this access control.
Persons have three additional access controls.
The first conceals the complete person record, based on a user defined restriction that is more granular than the line of business restriction.
For example, an access control to conceal person records that belong to the payer’s employees.
The second control restricts access to a person’s address information. The third restricts access to other contact details such as phone number and email address.