Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.5

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.5.

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-30383	UI: Coverage Regime Page This enhancement introduces the ability to view, create and edit Coverage Regime with a simplified representation in UI.
NXT-31023	Search Result Download in CSV Format This enhancement addresses the issue of referenced fields being downloaded in one column as JSON data in the CSV exports from UI. With this enhancement all the displayed data of a reference field will be downloaded into separate columns.
NXT-31592	Conditionally disable actions for the claims and policies page This enhancement introduces the ability to disable the following buttons conditionally: Submit claim Submit policy Edit policy Documentation Links: Developer Guide - JET User Interface - Components - Condition

Summary

Patch

NXT-30383

UI: Coverage Regime Page

This enhancement introduces the ability to view, create and edit Coverage Regime with a simplified representation in UI.

NXT-31023

Search Result Download in CSV Format

This enhancement addresses the issue of referenced fields being downloaded in one column as JSON data in the CSV exports from UI. With this enhancement all the displayed data of a reference field will be downloaded into separate columns.

NXT-31592

Conditionally disable actions for the claims and policies page

This enhancement introduces the ability to disable the following buttons conditionally:

Submit claim
Submit policy
Edit policy

Documentation Links:
Developer Guide - JET User Interface - Components - Condition

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-30383	Modified	CL0005 Coverage Regimes page Modified existing hierarchical detail pages into a single page to enable users to view, create, and edit the regimes in a simplified layout

Ref

Action

Description

NXT-30383

Modified

CL0005 Coverage Regimes page

Modified existing hierarchical detail pages into a single page to enable users to view, create, and edit the regimes in a simplified layout

Breaking Changes

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Access Restrictions

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Bug Fixes

BugDB	SR	Internal	Summary
38440675		NXT-32574	Downloaded CSV file contains the default records rather than the sorted records displayed on the pages with Search Object template
Description:	In pages configured using Search Object template, sorted records are not downloaded in excel. Instead initial results are downloaded
Resolution:	In pages configured using Search Object template, sorted records are getting downloaded in the CSV now and the previous results are no longer retained.
38338275		NXT-32334	Person’s formatted name is not displayed in Claims page
Description:	Person’s formatted name is not displayed in claims detail page and search page.
Resolution:	The person’s formatted name now displays consistently on the Claims Detail Page, Claims Search Page based on configuration.
38391500		NXT-32473	Values not displayed in widgets once page refresh is done in dashboard pages
Description:	When widget is added in any dashboard page and the page is refreshed, the values are not displayed.
Resolution:	Widget is loading as expected in the dashboard page.
38504351	3-40770729791	NXT-32702	Search is not triggered on intended reference for String based List of values
Description:	When a List of value is configured based on a string in the lookup, the query is currently triggered using the properties of the List of value floorplan. Instead, it should be triggered using the property name from the payload.
Resolution:	The query is executing as expected and returning the correct results for the string based list of values
38181520		NXT-32076	Diminishing rates page is not displaying data accurately
Description:	As per the functionality, any diminishingRateBlockSizeList or diminishingRateBlockAmountList entries linked via a reference key to the provider pricing clause tab on the Pricing Worksheets page should not be displayed on the page
Resolution:	Override diminishingRateBlockSizeList or diminishingRateBlockAmountList records are excluded from the page as expected
38223061		NXT-32121	Pricing work sheet built and validated details are updated when draft provider pricing clause is built or validated
Description:	The last built date and validated date and corresponding user details on pricing worksheet are updated when a draft provider pricing clause created using that worksheet is validated or built.
Resolution:	The last built date and validated date and corresponding user details on pricing worksheet are now not updated when a draft provider pricing clause created using that worksheet is validated or built.
38386413		NXT-32457	Extensibility search is automatically filled with the searched organization provider
Description:	The search criteria used on the organization providers page is carrying over to the extensibility tabs search when the organization providers detail page is opened.
Resolution:	The search criteria is not retained now in extensibility tabs
38462995		NXT-32627	Coverage label picked up during application startup isn’t deterministic
Description:	During application startup, the coverage label selected as ORIGINAL is determined by the 'O' action type. However, starting with version 4.25.1.0.0, two additional coverage labels with the same 'O' action type have been introduced. The expected behavior is to always select the CoverageLabel with the code "ORIGINAL". But since there is no sorting applied, the selected label is non-deterministic.
Resolution:	Updated the logic to always fetch the CoverageLabel with the code "ORIGINAL" during application startup.
38456485	3-42052130431	NXT-32609	Reference sheet lines export is prefixed with the "=" symbol for number values saved in char field.
Description:	Number values saved in a char field are prefixed with the "=" symbol whenever they are exported in the application.
Resolution:	Number values saved in a char field are not prefixed with the "=" symbol whenever they are exported in the application.
38478782		NXT-32666	Resolving a pend requires a delete access grant
Description:	When a pend is configured with an access restriction, users requires a delete access grant on the access restriction code in order to resolve the pend.
Resolution:	Resolving a pend needs only update access grant on Data Access Restriction on pend reason
38478914		NXT-32667	Sub-Claim’s claim line level pends are not getting reattached during processing
Description:	Pend rule is not reapplied to a subclaim’s claim line when a large claim is reprocessed.
Resolution:	Resolved pend rules are cleared upon claim submission. During reprocessing of a large claim, pend rules can now be reattached to the subclaim’s claim line.
38434992	3-42122630601	NXT-32552	Row level error icon is not visible in fee schedule line tab
Description:	Error icon is not showing in row level whenever business rule error occurs in table component
Resolution:	Error icon is shown in row level and business rule error is shown when user hovers over it

BugDB

Internal

Summary

38440675

NXT-32574

Downloaded CSV file contains the default records rather than the sorted records displayed on the pages with Search Object template

Description:

In pages configured using Search Object template, sorted records are not downloaded in excel. Instead initial results are downloaded

Resolution:

In pages configured using Search Object template, sorted records are getting downloaded in the CSV now and the previous results are no longer retained.

38338275

NXT-32334

Person’s formatted name is not displayed in Claims page

Description:

Person’s formatted name is not displayed in claims detail page and search page.

Resolution:

The person’s formatted name now displays consistently on the Claims Detail Page, Claims Search Page based on configuration.

38391500

NXT-32473

Values not displayed in widgets once page refresh is done in dashboard pages

Description:

When widget is added in any dashboard page and the page is refreshed, the values are not displayed.

Resolution:

Widget is loading as expected in the dashboard page.

38504351

3-40770729791

NXT-32702

Search is not triggered on intended reference for String based List of values

Description:

When a List of value is configured based on a string in the lookup, the query is currently triggered using the properties of the List of value floorplan. Instead, it should be triggered using the property name from the payload.

Resolution:

The query is executing as expected and returning the correct results for the string based list of values

38181520

NXT-32076

Diminishing rates page is not displaying data accurately

Description:

As per the functionality, any diminishingRateBlockSizeList or diminishingRateBlockAmountList entries linked via a reference key to the provider pricing clause tab on the Pricing Worksheets page should not be displayed on the page

Resolution:

Override diminishingRateBlockSizeList or diminishingRateBlockAmountList records are excluded from the page as expected

38223061

NXT-32121

Pricing work sheet built and validated details are updated when draft provider pricing clause is built or validated

Description:

The last built date and validated date and corresponding user details on pricing worksheet are updated when a draft provider pricing clause created using that worksheet is validated or built.

Resolution:

The last built date and validated date and corresponding user details on pricing worksheet are now not updated when a draft provider pricing clause created using that worksheet is validated or built.

38386413

NXT-32457

Extensibility search is automatically filled with the searched organization provider

Description:

The search criteria used on the organization providers page is carrying over to the extensibility tabs search when the organization providers detail page is opened.

Resolution:

The search criteria is not retained now in extensibility tabs

38462995

NXT-32627

Coverage label picked up during application startup isn’t deterministic

Description:

During application startup, the coverage label selected as ORIGINAL is determined by the 'O' action type. However, starting with version 4.25.1.0.0, two additional coverage labels with the same 'O' action type have been introduced. The expected behavior is to always select the CoverageLabel with the code "ORIGINAL". But since there is no sorting applied, the selected label is non-deterministic.

Resolution:

Updated the logic to always fetch the CoverageLabel with the code "ORIGINAL" during application startup.

38456485

3-42052130431

NXT-32609

Reference sheet lines export is prefixed with the "=" symbol for number values saved in char field.

Description:

Number values saved in a char field are prefixed with the "=" symbol whenever they are exported in the application.

Resolution:

Number values saved in a char field are not prefixed with the "=" symbol whenever they are exported in the application.

38478782

NXT-32666

Resolving a pend requires a delete access grant

Description:

When a pend is configured with an access restriction, users requires a delete access grant on the access restriction code in order to resolve the pend.

Resolution:

Resolving a pend needs only update access grant on Data Access Restriction on pend reason

38478914

NXT-32667

Sub-Claim’s claim line level pends are not getting reattached during processing

Description:

Pend rule is not reapplied to a subclaim’s claim line when a large claim is reprocessed.

Resolution:

Resolved pend rules are cleared upon claim submission. During reprocessing of a large claim, pend rules can now be reattached to the subclaim’s claim line.

38434992

3-42122630601

NXT-32552

Row level error icon is not visible in fee schedule line tab

Description:

Error icon is not showing in row level whenever business rule error occurs in table component

Resolution:

Error icon is shown in row level and business rule error is shown when user hovers over it

Issues that were backported in previous Release / Patch

No backports.