Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.5
This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.5.
| Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.23.1.x is only compatible with other Oracle Health Insurance applications release version 4.23.1.x unless explicitly stated otherwise. |
| As per the Service Description, you are obligated to request a service upgrade within 90 days of this release being generally available (GA). In line with the Oracle Cloud Services Pillar document, Section 4.2.2 End of Life, this release will be EOL in 12 months. |
Enhancements
| ID | Summary | Patch |
|---|---|---|
NXT-27561 |
Selective financial limit carryover This enhancement introduces the ability to decide whether an out-of-pocket-maximum (OOPM) limit consumption counts towards year-end carryover. For example: * An OOPM consumption from a coinsurance or a copay do not count towards a carryover. * An OOPM consumption from a deductible does count towards a carryover. A new indicator, |
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NXT-28020 |
Attach additional diagnoses to a claim This enhancement introduces new predefined methods to replace diagnosis codes in a claim or claim line as part of the automated process flow. The methods help map one type of diagnosis coding system to another, for example, from ICD-9 to ICD-10. Documentation Links: |
Web Services
| Ref | Action | Description |
|---|---|---|
NXT-27561 |
Modified |
Product Benefit Specification Integration Point Added Exclude From Carry Over indicator on product benefit specification limits |
Data Conversion
| Ref | Action | Description |
|---|---|---|
NXT-27561 |
Added |
Product Benefit Specification Limit Exclude From Carry Over indicator set to false |
Dynamic Logic
| Ref | Action | Description |
|---|---|---|
NXT-28020 |
Added |
deleteDiagnosis This method removes a diagnoses code from a claim or claimline through dynamic logic within a derivation rule. |
NXT-28020 |
Added |
addDiagnosis This method is adds a diagnoses code to a claim or claimline through dynamic logic within a derivation rule. |
UI Changes
| Ref | Action | Description |
|---|---|---|
NXT-27561 |
Modified |
ADF Setup product benefit specifications Added Exclude From Carry Over indicator |
Bug Fixes
| BugDB | SR | Internal | Summary |
|---|---|---|---|
36427800 |
3-35684326321 |
NXT-29041 |
Gathering statistics on technical table for every extract activity is inefficient |
Description: |
Gathering statistics on technical table for every extract activity is inefficient as it was enabled by default for all cases and because of parallel extracts performance was degraded. |
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Resolution: |
A check is added which will ensure statistics are gathered only in certain cases. Hence, improving the efficiency of extract activity. |
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