Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.21
This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.21.
| 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 |
|---|---|---|
CPN-3975 |
Optimized memory usage during dynamic field/records retrieval and activity processing through chunking strategy Memory utilization is improved during the retrieval of dynamic fields and records in the dynamic logic. A new predefined method, Write access is enabled for all dynamic fields of attachedPolicyData within "Policy Calculation Period Segments", allowing these fields to be modified using Groovy-style property access instead of the setDynamicField method (see "Policy Calculation Period Segments" in the Developer Guide). Additionally, activity processing chunking is introduced to further optimize memory usage. When enabled, activity groups are processed based on a configurable chunk size (default 100 MB), and transactions are committed once the defined threshold is reached to prevent excessive memory consumption, after which processing continues for the remaining activities of the group within the same iteration. Documentation Links: |
|
NXT-32464 |
Non-Unique Provider Identifiers This enhancement introduces enables the configuration setting that controls whether a provider identifier is unique across providers. |
|
NXT-33750 |
Enhance UI download functionality to include all search results based on query criteria. This enhancement extends the UI download feature to export the complete search result dataset matching the active query for select pages in claims and product definition application Claims
Product Definition
In addition, multiple pages based on floorpan templates 1) View and Edit Table, 2) Search Object - List, 3) Search Object - table and 4) Tab tables/list (exception dynamic records) within View and Edit HRR now support download API based download feature. Documentation Links: |
|
NXT-33780 |
Ability to build and Validate multiple draft provider pricing clauses across worksheet This enhancement introduces ability to build/validate multiple draft provider pricing clauses across multiple worksheets by removing the restriction of 10 distinct worksheet. |
Configuration Properties
| Ref | Action | Description |
|---|---|---|
NXT-33750 |
Added |
ohi.api.download.max.rows The ohi.api.download.max.rows system property, which allows users to configure the maximum number of rows that can be downloaded through the Download API. By default, this property is set to 2,000 rows. The maximum supported value is capped at 10,000 rows. |
Web Services
| Ref | Action | Description |
|---|---|---|
NXT-32464 |
Modified |
Provider IP If more than 1 provider is matched to an identifier, then an error message is thrown |
Data Conversion
| Ref | Action | Description |
|---|---|---|
NXT-32464 |
Removed |
Provider Identifiers Unique constraint on identifier and identifier type is dropped in all the applications. |
UI Changes
| Ref | Action | Description |
|---|---|---|
NXT-33750 |
Modified |
All floorplan based pages (and Reference Sheet Lines) API based download is enabled in UI pages. However, there is an exclusion list application wise:
Also, UI based download is retained in Extensibility tabs and tabs of some Detail pages:
|
NXT-33750 |
Modified |
Proddef - Product Service Definition (Products and Across) Boilerplate text value is updated for all the Regime fields to indicate the type of regime |
Breaking Changes
| Ref | Action | Description |
|---|---|---|
NXT-33750 |
Modified |
Below breaking change will be observed for UI download enhancement.
|
Bug Fixes
| BugDB | SR | Internal | Summary |
|---|---|---|---|
39435432 |
4-0002835185 |
NXT-34256 |
Workflow events are now created correctly for claims with multiple pend reasons |
Description: |
When a claim had multiple pend reasons in Manual Adjudication, accepting the claim after resolving one pend reason did not correctly continue the workflow for the remaining unresolved pend reasons. |
||
Resolution: |
This issue has been resolved. After one pend reason is resolved, the workflow task for that pend reason is completed and a new workflow event is created for the next unresolved pend reason. The claim continues to return CLA-CLAI-035 until all relevant pend reasons are resolved. |
||
39483107 |
NXT-34303 |
Diacritic search returns incorrect results for reserved words and special characters |
|
Description: |
Diacritic search returned incorrect results when search values contained reserved words or special characters. |
||
Resolution: |
Diacritic search now returns the correct results for values that contain reserved words or special characters. |
||
39539021 |
4-0002915946 |
NXT-34346 |
Tab table inline row action does not select claimline row before view/open action |
Description: |
In the JET claims page, when a claim line tab table row has only two row actions, the actions are rendered as direct clickable icons. Clicking the view/open icon does not select/check the row. When users opens a pended claim line in edit mode and clicks to resolve pend on claim line pend reason tab, a popup appears to confirm pend resolution. When user clicks 'OK', nothing happens. |
||
Resolution: |
It is now possible to resolve pend on claim lines from claim line pend reason tab even though only 2 row actions are enabled |
||
39570597 |
4-0002916902 |
NXT-34384 |
Claim line tab procedure details are cleared off when user navigates from claimline detail page |
Description: |
When a procedure is not configured in the Claim Lines Floor Plan and user navigates to claim lines detail page, clicks on Apply button, the data in the Claim Lines tab table is cleared off. |
||
Resolution: |
Procedure details are retained in claimlines tab table even when the fields are not included in details page floorplan |
||
39564250 |
4-0002952166 |
NXT-34372 |
Resolve pend prompt defaults to Cancel when pressing Enter key on claims pend screen |
Description: |
When user clicks the Resolve link for the claim pend reason, the Resolve Pend pop-up opens. If the user presses Enter on the keyboard instead of resolving the pending reason, the Cancel action is triggered. |
||
Resolution: |
Resolve pend prompt defaults to Ok when pressing Enter key on claims pend screen and the pend is resolved. The issue is also fixed in Search Claim lines, claim line tab table, Large Claims page |
||
39524374 |
NXT-34335 |
The zip generated by object generation endpoint includes Claim.groovy references to SubClaimHolder and SubClaimLineHolder, but does not include generated Groovy files for those holder classes. |
|
Description: |
The object generation endpoint builds the zip from classes known to the metamodel. SubClaimHolder and SubClaimLineHolder are non-persistable helper classes returned by Claim.getSubClaimHolder() and Claim.getSubClaimLineHolder(). Since they are not JPA/persistable classes and are not registered as auto-discoverable metamodel classes, they are not included in MetaModelImpl.getClasses() and therefore no Groovy skeleton files are generated for them. This causes the generated zip to contain references to missing classes. |
||
Resolution: |
Updated logic such that object generation endpoint builds the zip including SubClaimHolder.groovy and SubClaimLineHolder.groovy |
||
39581245 |
4-0003050818 |
NXT-34400 |
Feeschedule lines does not have fee-schedule code in search in Config Migration Sets dialog |
Description: |
When users need to create configuration migration set, Fee-Schedule line dialog does not have fee-schedule code as one of the criteria in quick/advanced search for selection. Users won’t be able to add set of fee-schedule lines for specific set of fee-schedule codes in the package for migration. |
||
Resolution: |
Fee-schedule code in added to quick and advanced search for Fee Schedule Lines Config Migration Sets dialog |
||
39450749 |
4-0002615815 |
NXT-34267 |
Reference Sheet searches may not display recently updated records immediately in non-production environments because of search index synchronization delays |
Description: |
Previously, updates made through the Reference Sheet maintenance process might not immediately appear in search results due to the configured search index synchronization interval. To improve the user experience in non-production environments, the indexing behavior for Reference Sheet data has been changed from periodic synchronization to on-commit indexing. This allows search results to reflect committed changes immediately, making testing and validation activities more efficient. |
||
Resolution: |
Fix is provided in non-production environments to address delays between Reference Sheet data updates and search index synchronization. With this change, search results now reflect committed updates immediately, eliminating the temporary inconsistency where recently modified records were not available in search results until the next index synchronization cycle. |
||
38868763 |
4-0001673378 |
NXT-33408 |
LARGE_CLAIM_SUBMIT activity always fails if any sub claim is having existing errorred task |
Description: |
If sub claim is having ERRORED task (ClaimEvent), submitting large claim always results into "Submit activity of type LARGE_CLAIMS_SUBMIT failed, click on view for more details" error. |
||
Resolution: |
If sub claim is having ERRORED task (ClaimEvent), submitting large claim does not result in an error. |
||
39618760 |
4-0003063146 |
NXT-34456 |
Remove Message from the claim line More menu causes a stale claim version error on Save |
Description: |
When a claim is in edit mode, removing a claim line message through the bulk/action dropdown sends a PATCH request that updates the claim on the server. This increments the claim version, but the UI did not refresh the claim header/object version afterward. As a result, the next explicit Save submitted the old version and Claims raised an optimistic locking error: the claim had changed since it was last read. |
||
Resolution: |
After a successful remove-message PATCH, the UI now reloads the claim objectVersionNumber and updates the in-memory claim before the user saves, so the subsequent Save uses the current version and no longer triggers GEN-RULE-020. |
||
39561667 |
4-0002489461 |
NXT-34369 |
External consumption create or resolve counter periods using an incorrect period when explicit startDate and endDate are provided in the request. |
Description: |
When external consumptions were processed for a counter with existing historical consumptions, the requested consumption startDate and endDate could be incorrectly modified during counter period interval calculation. This could cause the system to either create a counter period with an incorrect start date or fall back to an existing counter period instead of creating the expected new counter period. This was observed when the aggregation level/product changed, and also when the aggregation level/product remained the same. |
||
Resolution: |
The counter period calculation logic now preserves the external consumption request dates while evaluating historical consumption intervals. If no applicable counter period exists, the new counter period is created using the startDate and endDate passed in the external consumption request. |
||
39547633 |
4-0002944710 |
NXT-34354 |
Pre-pricing derived claim diagnoses are not considered for benefit specification diagnosis group matching |
Description: |
When claim diagnoses are added through a pre-pricing derivation rule using the claim.addDiagnosis() method, the derived diagnoses are not considered during benefit specification evaluation for diagnosis groups with usage scope "In" when no diagnosis type is defined on the benefit specification. As a result, benefit specification selection fails and the claim processing returns error CLA-FL-BENS-019, even though the derived claim diagnoses should satisfy the diagnosis group criteria. |
||
Resolution: |
Benefit selection now correctly considers diagnoses that are added by pre-pricing derivation rules, including diagnoses added at both the claim level and the claim line level. This ensures that benefit specifications with diagnosis group criteria are evaluated using the latest diagnosis information available on the claim. |
||
38121664 |
NXT-31926 |
Adjudication Limit Counters: Unable to fetch claim code under limit consumptions quick search |
|
Description: |
In Adjudication Limit Counters page, unable to fetch claim code in limit consumptions section |
||
Resolution: |
Quick search now works on claim code and Description. Advanced search has also been added based on 3 fields - Reserved?, Service Date and Transaction Date |
||
39410117 |
NXT-34225 |
Undefined Value Appears in Certain Fields of Copied Claim Lines |
|
Description: |
When user copies a claimline and navigates to the claim line details page for the copied row, updates a few details, and clicks Back to Claim then some fields are not updated, and undefined appears in the currency field. |
||
Resolution: |
Proper values are retained/updated in currency field of claimline table |
||
39505599 |
4-0002904344 |
NXT-34321 |
CTR Claim and CTR Claim Line Message banners display only message text |
Description: |
Message code is not displayed in CTR Claim and CTR Claim Line Message banners. |
||
Resolution: |
CTR Claim and CTR Claim Line Message banners to display both message code and text |
||
39536040 |
4-0002914777 |
NXT-34342 |
User with Retrieve Access to 'CL0172' is able to push claims using IP |
Description: |
User with only Retrieve Access to Claims page 'CL0172' is able to push claims into OHI claims using ClaimsIn IP "/api/claims". |
||
Resolution: |
Removed the ClaimsIn IP mapping for Claims page access 'CL0172'. So, users with only Retrieve Access to 'CL0172' cannot insert claims using /api/claims |
||