Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.23
This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.23.
| 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. |
Bug Fixes
| BugDB | SR | Internal | Summary |
|---|---|---|---|
39723407 |
4-0003227608 |
NXT-34581 |
Large Claim finalization fails with CLA-CLAI-021 when a pre-finalization external intervention triggers reprocessing |
Description: |
After all the subclaims are finalized successfully, the system starts the parent Large Claim’s pre-finalization processing. When an applicable external intervention rule produces a reprocessing outcome, the parent Large Claim is reprocessed During persistence, the generic claim-line validation is applied to the parent and raises:CLA-CLAI-021: Not allowed to submit a claim that does not contain claim lines. This validation is inappropriate for a Large Claim parent because its claim lines belong to its associated subclaims. A Large Claim parent is not expected—and is otherwise not allowed—to contain claim lines. |
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Resolution: |
Validation message CLA-CLAI-021 is not applicable to large Claim, If an External Intervention Rule exists on a Large Claim it will move to InProcess for reprocessing when the outcome is Reprocess; or be finalized automatically when no intervention prevents finalization. |
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39712828 |
4-0002995712 |
NXT-34565 |
Covered amount on claim line Is 0 with default currency when benefits input amount is null |
Description: |
When claim lines are being denied before the benefits input amount gets calculated , the covered amount on the claim line is being filled with 0.00 in default currency. This causes a trouble in calculating the total covered amount on the claim if other not denied claim lines have a currency that is different from default currency. |
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Resolution: |
Claimline with covered amount as 0 in any currency will not be considered in calculating the total covered amount. |
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38256583 |
NXT-32182 |
Conditional Display of Non-Matched Fields is Not Working on Claim and Claim Line Screens |
|
Description: |
When a claim is created through Claims IP and the required code is not present in the OHI system, the Claim and Claim Line screens display non-matched fields to assist with claim review. Due to an issue in the conditional display logic, some non-matched fields are not displayed even when the configured conditions were met. |
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Resolution: |
The conditional display logic has been modified on the Claim and Claim Line screens. Some non-matched fields that were previously not displayed are now rendered correctly when the configured conditions are satisfied, ensuring the expected information is available during claim processing. |
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39813499 |
4-0003367173 |
NXT-34673 |
Claim Line actions displays two Select all options in results view floorplan |
Description: |
Claim Line actions are not working with single claim line selection in results view. |
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Resolution: |
Claim Line actions are now working correctly for both single-line selection and "Select All" selection in the Result View |
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39797239 |
NXT-34653 |
Unable to Resolve claim line pend with "Resolve Pend Reason" button |
|
Description: |
When user selects a claim line with an unresolved pend in claimline results view, clicks on the Resolve Pend Reason button, and then try to resolve selected pend reasons from the dialog, there is an error "CLA-IP-RPND-008: Pend reason code is not specified" |
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Resolution: |
The Resolve Pend Reason dialog now allows the user to resolve the selected pend reason successfully without any validation errors |
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