Release Notes for Oracle Health Insurance Claims Adjudication Patch 3.20.2.0.9

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 3.20.2.0.9.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 3.20.2.x is only compatible with other Oracle Health Insurance applications release version 3.20.2.x unless explicitly stated otherwise.

Enhancements

No enhancements.

Upgrade Steps for Installation

To perform the upgrade, perform the following steps:

  1. Perform any pre-upgrade steps.

  2. Stop all the managed nodes running the .existing version of the application.

  3. Perform any pre-undeploy steps.

  4. Undeploy the existing version of the application.

  5. Back up the database.

  6. Perform any post-undeploy steps.

  7. Unpack the release bundle into a directory that we refer to as OHI_ROOT from now on.

  8. Change Installation Configuration: In <OHI_ROOT>/util/install, make a copy of ohi_install.cfg.template and name it ohi_install.cfg.

  9. Edit ohi_install.cfg to contain your specific database connection data and other configuration settings. The settings are explained in the file itself.

  10. Make sure NO connections are present to the database using the OHI_xxx_USER account (where xxx is the abbreviation of the application)

  11. Run the Upgrade script:

    1. Open a command window and browse to <OHI_ROOT>/util/install.

    2. Run the upgrade by executing ./ohi-update.sh .

  12. Make the required changes to the ohi properties file

  13. Perform any post-upgrade steps

  14. Start WebLogic application server

  15. Deploy the Application

  16. Perform any post-deploy steps

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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Deprecated items (to be removed in future release)

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Breaking Changes

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Bug Fixes

BugDB SR Internal BP Summary

32519594

3-25047894481

NXT-22086

BP

Claims Reprocess Integration Point should mark the existing pend reasons as resolved

Description:

Pend resolution details do not show resolved_date_time, resolved_by_user etc in the pend reason history when the pend is resolved during claims reprocess via 'api/claimsreprocess and api/claimsreprocesscriteria' IP.

Resolution:

Now the existing pend reasons are marked as resolved with timestamp using the information from the user context. This is logged in user for online reprocessing request and system user for batch reprocessing requests.

32554930

3-25162308611

NXT-22160

BP

Duplicating a claim line which has a value for an Overriding Claim Line parameter gives error

Description:

Duplicating a claim line which has a value for an Overriding Claim Line parameter gives the below error : GEN-ORA-00001: THIS CLAIM LINE OVERRIDE ALREADY EXISTS
Expectation is that no error message should be shown and claim line should be added without any errors.

Resolution:

Duplicating a claim line which has a value for an overriding Claim Line parameter does not give error anymore. Now if a claim line has values for any of the below fields, then those values will not be available in the new duplicated line.
Family Code
Coverage Regime (Auth)
Funding Arrangement
Product Family
Product Line
Product
Coverage Specification
Coverage Regime (No Auth)
Post Benefits Regime
Waiting Period Regime Authorization Regime

32592982

3-25255922421

NXT-22213

BP

CLA-FL-BENS-066 error is attached to claimline even when policy product exists

Description:

When there are multiple policy products for the same product, application intermittently picks up the wrong policy product and this causes CLA-FL-BENS-066 error.

Resolution:

The product is not reselected when previous products are added. This avoids CLA-FL-BENS-066 error.

32633574

3-25359046661

NXT-22271

BP

Currency conversion (payment) signature executed once per claim

Description:

Exchange rates are calculated incorrectly if the dates on claims lines differ from the last claim line. Conversion (Payment) signature dynamic logic is only executed once per claim for claim line with the most recent start date, instead of per claim line.

Resolution:

Exchange rates are now calculated correctly for each claim line with different dates. Conversion (Payment) signature dynamic logic is executed for claim lines based on distinct start date, instead of once per claim.

32656541

3-25194388651

NXT-22305

BP

Benefits task should not fail with NPE if incorrect subscription date is returned by the enrollment response

Description:

Enrollment Information regarding contracts of some claims is outside the scope of the claimLine service date which leads to null pointer exception (NPE) at benefits task. Reprocessing these claims by sending them again with claims in and overwrite flag resolves the issue. But , NPE still need to be avoided .

Resolution:

A new message "CLA-FL-BENS-068" has been introduced for such scenarios. This will be attached to claim line message with message description as "Unable to complete benefit selection successfully". Also, an error message will be logged in log file .

32663843

3-25194388651

NXT-22324

BP

Claim processing fails with NPE in finalize task when consumptions are finalized before periods

Description:

When there are no existing provider limit counter periods for the provider limit counter, then application returns null which cause Null pointer exception and claim gets stuck. However, there are preliminary provider limit counter periods that should be finalized before finalizing consumption. So sometimes that doesn’t happen in the same order as intended, which is periods before consumption.

Resolution:

It is ensured that periods are finalized before consumption and that those finalized periods are available to be queried while finalizing consumption. Also, null check is added incase if no periods are found.

32663806

3-25194388651

NXT-22327

BP

NPE in benefits step is seen where claim has claimline(s) having case definition details as ancillary lines.

Description:

When a claim has multiple policy product including history with same product, there are multiple product benefit specifications for this product because initial selection happens based on the policy product and not on the product. In OHI, if a claimline is an ancillary detail to the case definition attached to the ben spec, then those lines are deleted. Since there are multiple product benefit specifications selected for the same benefit specification, when second time the same benefit spec is processed, it again tries to delete ancillary lines which are now no longer there, and hence gets Null Pointer Exception (NPE).

Resolution:

One product is selected only once. The benefitspecification selection cache is extended to have product id as key and not policy product id .

32718141

3-25228475161

NXT-22386

BP

Claims search in GUI taking long time.

Description:

Queries having call for table(ohi_util_pkg.split_ids(:1)) calculates wrong cardinality estimated rows as 8k due to which query uses poor plan. As a result search query takes long time.

Resolution:

This issue is fixed by implementing extensible optimizer feature available from Oracle DB 12.2 onwards. Query performance is now improved.

Issues that were backported in previous Release / Patch

No backports.