Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.2.0.2

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.2.0.2.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.23.2.x is only compatible with other Oracle Health Insurance applications release version 4.23.2.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-24066

WebLogic authentication implemented compliant with the Java Authorization and Authentication Service (JAAS) specification

This enhancement introduces support for the SAML 2.0 authentication mechanism in the Oracle Health Insurance. Additionally, a new JAR file named "CustomIdentityAsserter" has been created to accommodate the Basic Auth configuration.

Refer installation guide for further detail.

4.23.1.0.8

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, exclude from carry over is introduced on the product-benefit-specification limit to help make this decision. The decision acts as input to evaluate a coverage regime.

4.23.1.0.5, 4.23.1.0.8

NXT-28465

Optimize REST graph recreation of reference sheet line when a new reference sheet is created

To optimise the memory load while recreating Rest Graph for Reference Sheet Line when a Reference Sheet creates every time, some java files are modified as per flow and few java files are deleted. One index has been added with respect to column TEC_ELEMENT_CODE in table OHI_REFERENCE_SHEETS

Slices which were involved in this enhancement are common, datafileprocessing, referencesheets.

There are multiple scenarios through which ReferenceSheetLine(s) is/are created. * Bulk upload of data file set using import activity * Generic collection patch api * Create Reference Sheet Line through Generic API & ReferenceSheetLines IP.

Functionality has remain same. Only improvement is done in the perspective of memory optimisation.

4.23.1.0.8

NXT-29119

Claims page performance improvements.

Optimize the loading time of the claims page to improve overall performance. The load time of the claims page is improved by reducing the response sizes of requested data, parallelization of data calls and deferring unused calls.

4.23.1.0.8

NXT-29163

Add logging to diagnose duplicate policy products issue in enrollment callout

In Oracle Health Insurance Claims Adjudication and Pricing we are adding logging to capture the unique key violation and log the enrollment response received, to diagnose duplicate policy products issue in enrollment callout.

The log message contains the enrollment response received and logs it to the file only in case while processing the enrollment response a unique key violation occurs.

4.23.1.0.8

NXT-29214

Allow updating the serviced member for an existing episode with no episode details.

With this enhancement, it is now possible to update the serviced member for an existing episode with no episode details.

3.22.2.0.19, 4.23.1.0.7

POL-14132

Clearance of activities stuck in In Process stage from coherence submission caches using IP

Due to excessive load, the processing-pattern grid service stops processing activities, causing them to be stuck in the in process stage for a long time. Manually marking these activities to technical error (TE) and resubmitting them results in an exception as a reference to these activities already exist in coherence submission caches. Thus, the recovery of activities is only possible upon a full restart. The new integration point supports the clearance of coherence submission caches to facilitate the activity recovery process to avoid a complete restart.

4.23.1.0.8

Configuration Properties

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Web Services

Ref Action Description

NXT-27561

Modified

Product Benefit Specification Integration Point

Added Exclude From Carry Over indicator on product benefit specification limits

POL-14132

Added

clearsubmissioncaches IP

New IP to clear coherence submission caches.

Data Conversion

Ref Action Description

NXT-27561

Added

Product Benefit Specification Limit

Exclude From Carry Over indicator set to false

Dynamic Logic

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UI Changes

Ref Action Description

NXT-27561

Modified

ADF Setup product benefit specifications

Added Exclude From Carry Over indicator

NXT-27561

Modified

JET Setup Product Benefit Specifications

Added Exclude From Carry Over indicator

NXT-29119

Modified

Pend reason flow

Resolving a pend reason on claims disables or hides respective resolve links and avoids reload of the claim page.

Breaking Changes

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Bug Fixes

BugDB SR Internal Summary

36194650

NXT-28510

Add new row is shown at the last in table pages

Description:

Click Add new in table page. A new row is getting appended in the last visible row of the screen

Resolution:

Table component is modified with the below changes: 1) On click of Add button, a new row will be added to the top of the available rows. It is a sticky row to the table 2) Two new icons are added to a new row. Check icon would add the new row to the table and clicking on Cross icon would discard the new row. 3) User will have to click on Check icon and Save to persist the newly added data

36562892

3-34871101921

NXT-29272

Invoking exchange with filename containing diacritics corrupts created datafile name

Description:

Invoking exchange with file upload, where the filename contains diacritics, erroneously transforms the filename to some other characters.

Resolution:

By incorporating standard encoding for UTF-8 and ISO_8859-1 in multiform requests, filename with diacritics is not getting corrupted.

36704576

NXT-29540

Claim Callout History details are not displayed on Claim History Panel when toggle button 'Display Claim Callout History' is on

Description:

When a claim with Callout details is selected, the same must be visible in the Claim History drawer when 'Display Claim Callout History' is toggled on. However, the Callout details were not being displayed.

Resolution:

When a user selects a claim with Callout details, and toggles the 'Display Claim Callout History' to On state, a dropdown with the Callout title is shown under which a table displays the Callout details.

36456432

3-36247582081

NXT-29089

NEQ query operator & boilerplate issue in claims search page

Description:

NEQ query operator not working in advanced search. "queryOperator":"neq" is not working and have incorrect boilerplate text

Resolution:

Added support for neq for all datatypes in advance search

36195771

NXT-28520

All records are not shown in downloaded file, only 10 records are shown even after scrolling in table page

Description:

When a user scrolls through a set of records and clicks on download action in the table, the downloaded file doesn’t show the correct result.

Resolution:

All the records viewed in the table page is downloaded to the file when clicked on download action

36150783

NXT-28396

Add auto select feature to a field when only one result is available for LOV

Description:

Auto select of single result lov value only works when the lov has fetched that value and then you tab out else if the response has not yet come, the lov goes blank as soon as you tab out.

Resolution:

Auto selection of value for a lov field works fine when doing a tab out and single result is available

36079071

3-35014512371

NXT-28207

External consumption on sublimit does not create a counter period for its composite limit

Description:

External consumption on sublimit does not create a counter period for its composite limit.

Resolution:

External consumption on eligible sublimits can create composite limit counter periods as well

36515166

3-36366863461

NXT-29188

Evaluate condition not working on dynamic records in create mode

Description:

The evaluate condition is not working on dynamic records during create mode, but it works in view and edit mode.

Resolution:

Evaluate condition can be configured on dynamic records as well and it works fine in create and view-edit mode

36557433

3-36476824771

NXT-29259

Non-matched fields are not cleaning up once a match has been made.

Description:

Non matched field "Service Entity Code" is not cleared up when a matching Service Member is added to the claim.

Resolution:

Non-matched fields 'Service Entity Code' and Type are cleaned up once a matching Service Member is added to the claim

36740454

3-37077371621

NXT-29601

Unable to add usages under the external claims data floor plan

Description:

Unable to add usages under the External Claims Data floor plan when Auto Include Extensibility is not set.

Resolution:

Users can add usages under the External Claims Data floor plan when Auto Include Extensibility is not set to true

36715702

3-36973417771

NXT-29548

Custom property in rule parameters tab of product benefit specification is not working

Description:

Go to 'Product Benefit Specification' → Click on 'Rule Parameters'. Add values for all fields, you will observe that the field 'Type' is not editable

Resolution:

Type field in Product Benefit Specifications page is editable and the dropdown displays values % and currency which can be selected.

36654270

3-36452370811

NXT-29425

Advanced search lov’s for dynamic fields are not loading in referencesheetlines

Description:

Not able to search using the LOV’s in the reference sheet lines page. When clicking in the LOV field an error occurs on the api/generic/flexcodes/search.

Resolution:

Proper results are displayed in the LOV for flexcodes based on diagnosis, procedures and providers, displays

36504475

3-36403867421,3-36474555451

NXT-29167

Number fields in dynamic records are parsed incorrectly, when the accept language is passed.

Description:

The individual number field is interpreted correctly (as an English formatted number), but the number fields in the dynamic record are interpreted according to the language setting.

Resolution:

Number field in the dynamic record should not be parsed according to the language setting.

36675538

3-36864108701

NXT-29484

Issue with display of flexcodes in piechart for widget

Description:

Create a piechart widget with grouping criteria set on flex codes. Piechart doesn’t show flexcode names instead shows FlexCodeDomain(..)

Resolution:

PieChart widgets shows flexcode names properly when set as grouping criteria

36794974

NXT-29695

Page doesn’t reload after adding a record in Insurable Entity Type page.

Description:

Navigate to insurable entity type page and add a record. Save the record without clicking on check icon. Save successful message is displayed but page doesn’t reload, with the new record still in editable mode

Resolution:

Newly added rows are saved and page reloads in view mode

36556135

3-36386274101

NXT-29255

Recieving wrong currency error while adding new product benefit specification parameter

Description:

Create a product in ProdDef application with currency EUR and move it to OHI Claims. Try to add a new amount parameter with EUR currency for the product benefit specification in Claims. Wrong currency (USD instead of EUR) error is triggered, unable to add product benefit specification parameter

Resolution:

Product benefit specification Amount parameters can be added in any relevant currency and UI doesn’t give error about USD currency

36482471

3-35917534861

NXT-29135

Claimline sequence should be added for new row based on the maximum sequence available

Description:

ClaimLine sequence for newly added row must be set based on max sequence existing and incrementing it by one. When a claim has 5 claimlines and claimline 4 is deleted and a new one is added, JET shows error message that Claimline-5 already exists since JET calculates the sequence based on number of rows present.

Resolution:

Claimline sequence for a newly added row is calculated based on the maximum sequence available and incrementing by 1 for every new row.

36393308

3-35684326321

NXT-28972

Data from technical table is not cleaned up if an extract activity fails which leads to data accumulation

Description:

Data from technical tables were only getting cleaned for activities in 'CO' status. Which was causing accumulation of huge data.

Resolution:

Along with status 'CO' all other statuses except 'IN', 'IP' and 'QD' are now included as part of cleaning process. This ensures a more cleaner technical table, hence overcoming the issue of data accumulation

36492013

3-36178158771

NXT-29145

PII data is not correctly populated when setting corresponding property

Description:

PII data is filled in as NULL when setting property "ohi.baseview.exclude.pii" to false, even though they are not null. This is only the case for entities where certain attributes are PII if the entity is of a certain subtype, e.g. for Relation of subtype 'PERS', the code column is seen as PII. When the "ohi.baseview.exclude.pii" property is set to false, this data should be seen.

Resolution:

PII data is now correctly populated when setting property "ohi.baseview.exclude.pii" to false.

36593624

NXT-29326

Remove the usage of utl_tcp DBMS package in extract functionality

Description:

Using utl_tcp DBMS package requires explicit grant in SaaS environments. This has operational challenges as the grants that are explicitly granted are periodically revoked by DBA as part of a scheduled process

Resolution:

Removed the usage of utl_tcp DBMS package in extract functionality and replaced it with a standard DB function

36274923

NXT-28698

Non-selective criteria in reference objects cause OHI to load too many objects in memory.

Description:

Non-selective criteria in reference objects cause OHI to load too many objects in memory.

Resolution:

Non-selective criteria in reference objects now only load two objects in the memory, which will not cause the memory protector to kick in.

36662916

NXT-29434

QD status activities are not set to TE during system startup

Description:

Activities that were not processed and in 'QD' status before system down, are not setting up to status 'TE'

Resolution:

During system startup, activities which are in status 'QD' will be set to status 'TE'

36498472

3-36339863591

NXT-29156

Cover Withhold amount with value 0 is not displayed

Description:

Multivalue having number fields set to 0 doesn’t display and CWC amount with value 0 is not displayed

Resolution:

Multivalues having number fields set to 0 displays and CWC amount with value 0 is displayed

36158149

NXT-28422

Init Condition - Default property is not working for LOV fields

Description:

Default value configured in floorplan for LOV fields is not applied ( displayed in UI) when used with init conditions

Resolution:

Default value configured in floorplan for LOV fields and dynamic records gets displayed in UI with init conditions

36618950

NXT-29382

Conditional evaluation is not working on primitive type LOV fields

Description:

Conditional evaluation is not working on primitive-type LOV fields while referencing any of the properties of lov selected.

Resolution:

Conditional evaluation is working on primitive type LOV fields.To enable field1 to have the entire context of the selected LOV value, we add a new attribute to the entity (context of the parent resource). This new attribute will be named 'name_of_FieldObj'. For the example above, it will be 'field1Obj', which will contain the entire context of the selected LOV value. This allows us to conditionally evaluate various scenarios by accessing context.field1Obj.code, and other similar fields.

36506848

NXT-29181

Unable to update the provider limits amount using the UI

Description:

When user updates the provider limit rule using the UI, the amount is not being saved resulting in the UI error: "PRI-PLHE-001: The provider limit height must specify a maximum & Amount"

Resolution:

No errors while updating the provider limits amount using the UI

36448741

NXT-29075

In Product benefit specification page, rule parameters type should be lov

Description:

Select and view any product benefit specification, Add new to Rule parameters tab. Field type should be LOV but is shown as text field.

Resolution:

Field 'type' in Product benefit specification page, rule parameters tab is shown as lov dropdown

Issues that were backported in previous Release / Patch

No backports.