Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.15

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.15.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.25.1.x is only compatible with other Oracle Health Insurance applications release version 4.25.1.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-31594	JET : Save user preferences for table displays This enhancement enables saving of user preferences related to column selection and column width adjustment for select pages by clicking on "Save preference" button. All system/floorplan driven pages based on page templates 1) View Edit List pages and 2) Search Object Table having when flexColumn setting as true (note - default setting is true) Product Definition Product Service Definition table in products and across products page Claims Draft provider pricing clause table within worksheet and across worksheet page Fee Schedule lines Provider Pricing Clause Claim lines table within claims page Common Reference Sheets
NXT-33686	New boilerplate key for submit button in status CHANGE for claims page. This enhancement introduces a new boilerplate key for the Submit button when a claim is in status Change. In this status, users can choose either Benefits Only or Submit the claim by going through pricing flows. To make this distinction clearer, it will now be possible to rename Submit button to “Price” in status change.

Summary

Patch

NXT-31594

JET : Save user preferences for table displays

This enhancement enables saving of user preferences related to column selection and column width adjustment for select pages by clicking on "Save preference" button.

All system/floorplan driven pages based on page templates 1) View Edit List pages and 2) Search Object Table having when flexColumn setting as true (note - default setting is true)
Product Definition
- Product Service Definition table in products and across products page
Claims
- Draft provider pricing clause table within worksheet and across worksheet page
- Fee Schedule lines
- Provider Pricing Clause
- Claim lines table within claims page
Common
- Reference Sheets

NXT-33686

New boilerplate key for submit button in status CHANGE for claims page.

This enhancement introduces a new boilerplate key for the Submit button when a claim is in status Change. In this status, users can choose either Benefits Only or Submit the claim by going through pricing flows. To make this distinction clearer, it will now be possible to rename Submit button to “Price” in status change.

Configuration Properties

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Web Services

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Data Conversion

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Dynamic Logic

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UI Changes

Ref	Action	Description
NXT-33686	Modified	CL0172 Claims Page A new boilerplate, 'M_CLAIMS_ACTION_SUBMIT_CHANGE' is introduced for Submit button in change status

Ref

Action

Description

NXT-33686

Modified

CL0172 Claims Page

A new boilerplate, 'M_CLAIMS_ACTION_SUBMIT_CHANGE' is introduced for Submit button in change status

Breaking Changes

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Access Restrictions

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Bug Fixes

BugDB	SR	Internal	Summary
39005513		NXT-33683	Flex Code Base Views are both removed and updated at the same time
Description:	During Base View Generation, the generation of Flex Code Base View is unstable: (1) Concurrent update/remove operations occasionally targeted the same view, raising the Oracle error “table or view does not exist”. This happened intermittently. (2) The generator skipped creating some Flex Code Base Views whenever the Flex Code System code contained lowercase characters.
Resolution:	The update/removal operations are serialized to prevent errors like “table or view does not exist”. Flex Code Base Views are generated for Flex Code Systems with a code containing lowercase characters.
39062593		NXT-33785	The conditional setting of setToNull only works when display: never is also specified
Description:	When conditionally setting a property’s value to null using setToNull, the value is only set to null if the display property is already 'never' or if 'display: never' is explicitly included in the condition.
Resolution:	It is possible to set any property to null without display: never setting
38924693		NXT-33547	Enhanced IP call does not resolve dynamic field fexcodes
Description:	When user creates a dynamic field on claimlines entity referencing procedures LOV and add it to the floorplan, newly added flexcode field is not resolved using Enhanced IP
Resolution:	Flexcodes are resolved and values are displayed in UI using Enhanced IP call
38984675		NXT-33657	Auto release of financial holds not released on new version of claim
Description:	When a financial hold is created for a working copy of a claim, if the claim is unfinalized and finalized again, the active hold is not released.
Resolution:	The active financial hold is properly released released on new version of claim
38509980		NXT-32708	Missing secrets for OAuth clients while ohistore is used as keystore
Description:	Sometime OAuth clients shows clientSecretRegistered as false even through secret is already set in the database.
Resolution:	OAuth client credential keys are now correctly fetched.
38975601	4-0002012731	NXT-33650	Duplicate Provider limit Consumption in Applied Pricing Section of Claim/Lines
Description:	After unfinalizing and resubmitting a claim, the Pricing Limit Consumptions table is displaying all consumptions. However, if a preliminary limit consumption exists for a limit, only the preliminary consumptions should be displayed. If no preliminary limit consumption exists for a limit, then the non-reversed limit consumptions should be displayed.
Resolution:	Fix added to show the applicable limit consumptions
38569048		NXT-32808	No action is performed in UI, on switching to blank sort by criteria
Description:	Once user apply’s a sort criteria using Sort By dropdown and selects the blank sort criteria, no action is performed in UI
Resolution:	Blank selection sets the sort criteria to default
39062556	4-0002102784	NXT-33784	Financial Hold is not released even after set expiration date and time is expired
Description:	The financial hold on the claim remains active even after the configured expiration date and time has passed
Resolution:	The financial hold status changes to Expired once it crosses the configured expiration date and time.
39051965		NXT-33769	Condition for including active brands only is missing for brands
Description:	All brands are shown in Claims page instead of active brands
Resolution:	Only active brands are shown in claims page
39045570	4-0002249826	NXT-33758	Configuration Migration Set Page - In View mode, migration items popup takes huge time to load records
Description:	In view mode, when user performs a search for entity 'Provider pricing clause and click on Migration Items hyperlink, pop up appears and takes huge time with load records.
Resolution:	The time taken to show selected records in view mode of CMT dialog is reduced and records load fast.
38925436		NXT-33552	Previously consumed auth remains in 'Approved' state even after claim is denied and also the fields which should be empty still have values
Description:	Previously consumed authorization remains in 'Approved' state even when the claim initially consumed it is denied in subsequent re-adjudication.
Resolution:	When the claim that initially consumed authorization gets denied in subsequent re-adjudication, the corresponding authorization is denied as well.
38975160		NXT-33644	No error message when trying to work on the same claim another user
Description:	Open the same claim using 2 different users, Unfinalize the claim using one of the user first. and when second user tries to unfinalize the same claim, there is no error in UI
Resolution:	An error message is displayed in the UI when multiple users perform action like unfinalize, submit etc on the same claim.
38527489	3-42354179211	NXT-32735	Task stuck if system runs into critical memory state while handling task result
Description:	Task stuck in PROCESSING status if system runs into CRITICAL memory state. To be specific, while handling task result if TooManyRequestsException is thrown, task status is never changed. TaskFlowProcessorImpl#processTaskFlow → following block should be fixed.
Resolution:	with this bug fix , the system will automatically changes the task status to errored when the system reaches memory critical state.
38377298		NXT-32412	Organization provider can be created with same provider as parent provider
Description:	When an organization provider is updated to refer to itself as parent provider, 500 response is returned. But in DB, the parent is mapped as same provider. After this, on searching for the provider 500 error is returned
Resolution:	When a customer creates or updates an organization provider and selects a parent that would create a loop, the save is rejected and a clear validation error REL-IP-PROV-012 is displayed.
39069137		NXT-33789	Enhanced Floorplan endpoint should not throw Null Pointer exception when usage name for insurable entity does not match in floorplan.
Description:	Enhanced Floorplan endpoint throws a NullPointerException when the usage name of an insurable entity does not match the value configured in the floorplan. NullPointerException is also seen when a flexcode field of type code is configured in the floorplan with ohi.service.queryapi.get.support enabled. These scenarios cause the endpoint to fail unexpectedly.
Resolution:	Fix added to prevent NullPointerException and ensure the endpoint handles these configurations correctly.
38998251		NXT-33662	Previously Consumed Auth Remains In 'Approved' State Even After Claim Is Denied
Description:	The authorization consumptions API response does not include information about consumed values.
Resolution:	The authorization consumptions API response now includes information about cosumedAmount, consumedNumberOfUnits and consumedServiceDays.
38817745		NXT-33311	Oauth restclientbuilder lookup fails due to duplicate enum keys across authentication feature enums
Description:	A key mismatch occured due to duplicate OAuth enum values defined in different authentication feature enums, resulting in a lookup failure and the error “No RestClientBuilder specified for OAuth”
Resolution:	The application now correctly resolves the restclientbuilder specified for OAuth
38904208		NXT-33523	System throwing NullPointerException when there is no value for EXCL_PHI_LOGGING in the OHI_REPORTING_VIEWS table
Description:	When invoking the Data Transfer IP, the system verifies if any PHI information is fetched and creates PHI log entries when needed. In case the EXCL_PHI_LOGGING column in the OHI_REPORTING_VIEWS table is empty, the system throws a NullPointerException.
Resolution:	The EXCL_PHI_LOGGING column in the OHI_REPORTING_VIEWS table gets a default value 'N'
39075287	3-42049799881	NXT-33806	View Technical Error Page takes long time to respond
Description:	With high volume of data, a quick search in task type takes long time to show results.
Resolution:	Prefilter used to display results in this page is modified so that there is a significant improvement in search.
39020568		NXT-33720	Object storage operation cause assert or Weblogic asserts at event publishing time in absence of missing class loader context in underlying thread
Description:	Object storage operation cause assert or Weblogic asserts at event publishing time in absence of missing class loader context in underlying thread. This resulted in import registration failures, failure observed at weblogic operation at time of publishing event.
Resolution:	Object storage operation cause assert or Weblogic asserts at event publishing time in absence of missing class loader context in underlying thread. Issue has been fixed by ensuring class loader context is always initialized

BugDB

Internal

Summary

39005513

NXT-33683

Flex Code Base Views are both removed and updated at the same time

Description:

During Base View Generation, the generation of Flex Code Base View is unstable:
(1) Concurrent update/remove operations occasionally targeted the same view, raising the Oracle error “table or view does not exist”. This happened intermittently.
(2) The generator skipped creating some Flex Code Base Views whenever the Flex Code System code contained lowercase characters.

Resolution:

The update/removal operations are serialized to prevent errors like “table or view does not exist”. Flex Code Base Views are generated for Flex Code Systems with a code containing lowercase characters.

39062593

NXT-33785

The conditional setting of setToNull only works when display: never is also specified

Description:

When conditionally setting a property’s value to null using setToNull, the value is only set to null if the display property is already 'never' or if 'display: never' is explicitly included in the condition.

Resolution:

It is possible to set any property to null without display: never setting

38924693

NXT-33547

Enhanced IP call does not resolve dynamic field fexcodes

Description:

When user creates a dynamic field on claimlines entity referencing procedures LOV and add it to the floorplan, newly added flexcode field is not resolved using Enhanced IP

Resolution:

Flexcodes are resolved and values are displayed in UI using Enhanced IP call

38984675

NXT-33657

Auto release of financial holds not released on new version of claim

Description:

When a financial hold is created for a working copy of a claim, if the claim is unfinalized and finalized again, the active hold is not released.

Resolution:

The active financial hold is properly released released on new version of claim

38509980

NXT-32708

Missing secrets for OAuth clients while ohistore is used as keystore

Description:

Sometime OAuth clients shows clientSecretRegistered as false even through secret is already set in the database.

Resolution:

OAuth client credential keys are now correctly fetched.

38975601

4-0002012731

NXT-33650

Duplicate Provider limit Consumption in Applied Pricing Section of Claim/Lines

Description:

After unfinalizing and resubmitting a claim, the Pricing Limit Consumptions table is displaying all consumptions. However, if a preliminary limit consumption exists for a limit, only the preliminary consumptions should be displayed. If no preliminary limit consumption exists for a limit, then the non-reversed limit consumptions should be displayed.

Resolution:

Fix added to show the applicable limit consumptions

38569048

NXT-32808

No action is performed in UI, on switching to blank sort by criteria

Description:

Once user apply’s a sort criteria using Sort By dropdown and selects the blank sort criteria, no action is performed in UI

Resolution:

Blank selection sets the sort criteria to default

39062556

4-0002102784

NXT-33784

Financial Hold is not released even after set expiration date and time is expired

Description:

The financial hold on the claim remains active even after the configured expiration date and time has passed

Resolution:

The financial hold status changes to Expired once it crosses the configured expiration date and time.

39051965

NXT-33769

Condition for including active brands only is missing for brands

Description:

All brands are shown in Claims page instead of active brands

Resolution:

Only active brands are shown in claims page

39045570

4-0002249826

NXT-33758

Configuration Migration Set Page - In View mode, migration items popup takes huge time to load records

Description:

In view mode, when user performs a search for entity 'Provider pricing clause and click on Migration Items hyperlink, pop up appears and takes huge time with load records.

Resolution:

The time taken to show selected records in view mode of CMT dialog is reduced and records load fast.

38925436

NXT-33552

Previously consumed auth remains in 'Approved' state even after claim is denied and also the fields which should be empty still have values

Description:

Previously consumed authorization remains in 'Approved' state even when the claim initially consumed it is denied in subsequent re-adjudication.

Resolution:

When the claim that initially consumed authorization gets denied in subsequent re-adjudication, the corresponding authorization is denied as well.

38975160

NXT-33644

No error message when trying to work on the same claim another user

Description:

Open the same claim using 2 different users, Unfinalize the claim using one of the user first. and when second user tries to unfinalize the same claim, there is no error in UI

Resolution:

An error message is displayed in the UI when multiple users perform action like unfinalize, submit etc on the same claim.

38527489

3-42354179211

NXT-32735

Task stuck if system runs into critical memory state while handling task result

Description:

Task stuck in PROCESSING status if system runs into CRITICAL memory state. To be specific, while handling task result if TooManyRequestsException is thrown, task status is never changed.

TaskFlowProcessorImpl#processTaskFlow → following block should be fixed.

Resolution:

with this bug fix , the system will automatically changes the task status to errored when the system reaches memory critical state.

38377298

NXT-32412

Organization provider can be created with same provider as parent provider

Description:

When an organization provider is updated to refer to itself as parent provider, 500 response is returned. But in DB, the parent is mapped as same provider. After this, on searching for the provider 500 error is returned

Resolution:

When a customer creates or updates an organization provider and selects a parent that would create a loop, the save is rejected and a clear validation error REL-IP-PROV-012 is displayed.

39069137

NXT-33789

Enhanced Floorplan endpoint should not throw Null Pointer exception when usage name for insurable entity does not match in floorplan.

Description:

Enhanced Floorplan endpoint throws a NullPointerException when the usage name of an insurable entity does not match the value configured in the floorplan. NullPointerException is also seen when a flexcode field of type code is configured in the floorplan with ohi.service.queryapi.get.support enabled. These scenarios cause the endpoint to fail unexpectedly.

Resolution:

Fix added to prevent NullPointerException and ensure the endpoint handles these configurations correctly.

38998251

NXT-33662

Previously Consumed Auth Remains In 'Approved' State Even After Claim Is Denied

Description:

The authorization consumptions API response does not include information about consumed values.

Resolution:

The authorization consumptions API response now includes information about cosumedAmount, consumedNumberOfUnits and consumedServiceDays.

38817745

NXT-33311

Oauth restclientbuilder lookup fails due to duplicate enum keys across authentication feature enums

Description:

A key mismatch occured due to duplicate OAuth enum values defined in different authentication feature enums, resulting in a lookup failure and the error “No RestClientBuilder specified for OAuth”

Resolution:

The application now correctly resolves the restclientbuilder specified for OAuth

38904208

NXT-33523

System throwing NullPointerException when there is no value for EXCL_PHI_LOGGING in the OHI_REPORTING_VIEWS table

Description:

When invoking the Data Transfer IP, the system verifies if any PHI information is fetched and creates PHI log entries when needed. In case the EXCL_PHI_LOGGING column in the OHI_REPORTING_VIEWS table is empty, the system throws a NullPointerException.

Resolution:

The EXCL_PHI_LOGGING column in the OHI_REPORTING_VIEWS table gets a default value 'N'

39075287

3-42049799881

NXT-33806

View Technical Error Page takes long time to respond

Description:

With high volume of data, a quick search in task type takes long time to show results.

Resolution:

Prefilter used to display results in this page is modified so that there is a significant improvement in search.

39020568

NXT-33720

Object storage operation cause assert or Weblogic asserts at event publishing time in absence of missing class loader context in underlying thread

Description:

Object storage operation cause assert or Weblogic asserts at event publishing time in absence of missing class loader context in underlying thread. This resulted in import registration failures, failure observed at weblogic operation at time of publishing event.

Resolution:

Object storage operation cause assert or Weblogic asserts at event publishing time in absence of missing class loader context in underlying thread. Issue has been fixed by ensuring class loader context is always initialized

Issues that were backported in previous Release / Patch

No backports.