Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.26

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.26.

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.

Enhancements

No enhancements.

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

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Breaking Changes

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Access Restrictions

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Bug Fixes

BugDB SR Internal Summary

38185768

NXT-31578

Data File Sets IP does not return the message text in the response for error codes DAT-IP-DAFI-013 and DAT-IP-DAFI-014

Description:

When encountering error codes DAT-IP-DAFI-013 and DAT-IP-DAFI-014, the associated error messages are not being displayed in the response. The expected behavior is that the error messages corresponding to these error codes should be returned in the response, providing more context and information about the error

Resolution:

When a data file set cannot be downloaded because its ZIP file is quarantined or still undergoing virus scanning, the application now displays a clear message explaining the condition and next action.

40132054

4-0003993742

NXT-35244

Claim finalizes with 0 covered amount if even 1 denied claimline exists at manual adjudication

Description:

When a claim pended in Manual Adjudication has multiple claim lines, with at least one denied and others approved with covered amounts greater than zero, the claim’s total covered amount is greater than zero. However, when the member resolves the pend and approves the claim, the claim is approved with a covered amount of zero. The covered amounts on all previously approved claim lines are also set to zero.

Resolution:

The claim adjudication process has been updated to ensure that covered amounts and benefits are retained for approved claim lines, while covered amount cleanup is performed only for denied claim lines. Additionally, when at least one claim line is denied, the system now executes the end-pricing and end-benefits derivation rules at the appropriate claim and claim-line levels to ensure accurate calculation and consistency of claim amounts and benefits.

39410125

4-0002782929

NXT-34227

Mark cacheEnabled and invalidateLater as volatile in DynamicLogicServiceImpl to prevent stale cache state across threads

Description:

After dynamic logic was updated through CMT while the dynamic logic cache was disabled, some application nodes could continue executing the previously cached dynamic logic executable after the cache was enabled again. This could result in inconsistent calculation behavior across nodes because the latest dynamic logic definition from the database was not always used immediately after the CMT update.

Resolution:

The dynamic logic cache state flags used for cache enablement and delayed invalidation were made safely visible across threads. With this change, delayed invalidation requests made while the cache is disabled are reliably applied when the cache is enabled again. This ensures stale dynamic logic executables are invalidated and subsequent executions use the updated dynamic logic definition.

40070758

NXT-32583

Api/ip returning activity detail in response has different base urls under links

Description:

API/IP returning activity detail in response has different base URLs under links if "ohi.claims.application.baseurl" property value and request’s base URL is different.

Resolution:

REST-generated activity links now honour the incoming request LinkContext instead of rebuilding from a fresh global context. That means generic/global activity responses should stop mixing hosts when ohi.claims.application.baseurl differs from the request base URL.

40068218

4-0002548324

NXT-35074

Automatic recovery can fail to identify the latest errored task

Description:

When an earlier task has a higher identifier than a more recently created task, automatic recovery can fail to identify and recover the latest errored task.

Resolution:

Retrieval of errored tasks is optimized and based on latest creation date.

Issues that were backported in previous Release / Patch

No backports.