Release Notes for Oracle Health Insurance Claims Adjudication Patch 3.20.3.0.1

If you intend to import from Oracle Health Insurance Product Definition to Oracle Health Insurance Claims Adjudication via RESTful Product Benefit Specification Integration Point, please be aware that the version 3.20.3.0.1 will be required for both applications due to compatibility reasons.

Enhancements

ID	Summary	Description	Included in Patch
NXT-18059	RESTful Product Benefit Specification Integration Point	This enhancement introduces the HTTP counterpart for SOAP based Product Benefit Specification Integration Point. Implementation Guide: no change Integration Guide: Claims Database changes: no change Scenarios dynamic logic: no change

Summary

Description

Included in Patch

NXT-18059

RESTful Product Benefit Specification Integration Point

This enhancement introduces the HTTP counterpart for SOAP based Product Benefit Specification Integration Point.

Implementation Guide: no change
Integration Guide: Claims
Database changes: no change Scenarios dynamic logic: no change

Upgrade Steps for Installation

To perform the upgrade, perform the following steps:

Perform any pre-upgrade steps.
Stop all the managed nodes running the .existing version of the application.
Perform any pre-undeploy steps.
Undeploy the existing version of the application.
Back up the database.
Perform any post-undeploy steps.
Unpack the release bundle into a directory that we refer to as OHI_ROOT from now on.
Change Installation Configuration: In <OHI_ROOT>/util/install, make a copy of ohi_install.cfg.template and name it ohi_install.cfg.
Edit ohi_install.cfg to contain your specific database connection data and other configuration settings. The settings are explained in the file itself.
Make sure NO connections are present to the database using the OHI_xxx_USER account (where xxx is the abbreviation of the application)
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 .
Make the required changes to the ohi properties file
Perform any post-upgrade steps
Start WebLogic application server
Deploy the Application
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)

Ref	Action	Subject	Description
NXT-18059	Modified	SOAP Service for Product Import (Batch)	Replaced by REST. SOAP interface deprecated

Ref

Action

Subject

Description

NXT-18059

Modified

SOAP Service for Product Import (Batch)

Replaced by REST. SOAP interface deprecated

Breaking Changes

This section intentionally left blank.

Bug Fixes

BugDB	SR	Internal	BP	Summary
31973848	3-23876699351	NXT-21247	BP	CLAIM SUBMIT API LEADS TO UNINTENDED PEND RESOLUTION
Description:	The claim submit API (meant to support the submit button in the JET Claim page) exhibits different behavior from the submit button in the ADF Claim page. Pend reasons that are not resolved should not be auto-resolved through submitting a claim.
Resolution:	The Claim Submit API no longer automatically resolves reasons in the same transaction. Pend reasons have to be resolved explicitly prior to submitting. This ensures that a user always takes notice of potential issues with a claim.
32006838	3-23723613251	NXT-21290	BP	REFERENCE SHEET IMPORT ELEMENT DATATYPE IS NOT REGISTERED IN ALL THE NODES OF CLUSTER
Description:	Reference sheet Import element datatype is not registered in all the nodes of cluster. This issue is reproducible only in multi-nodes cluster setup. The following steps might help to reproduce. 1. Create a new reference sheet 2. Configure the property ohi.referencesheetimport.filereader.chunk.size to 2 (default is 5000) using properties API 3. Create a data file containing ~10 reference sheet lines and import using REFSHEETLINE_IMPORT activity.
Resolution:	Reference sheet lines should be imported successfully in multi-nodes cluster setup
32032749	3-24072465081	NXT-21322	BP	PREVENT PLAN YEAR OVERRIDE FOR NON-YEAR LIMITS
Description:	The functionality to override plan year periods (meant for plan anniversary changes) is overriding not only the actual year limits but also daily and monthly limits. This feature kick’s in when the enrollment response contains a value for the contract end date. The current system behavior is that - during calculation - any limit that uses the reference 'plan year' automatically applies a counter period based on the contract start and end date extracted from the response. The fix is to add an additional condition to this feature that checks the configured renewal period length on a limit, so that only limits with (1) AND a reference date equal to the plan anniversary day (this condition is already implemented) (2) AND with a single year as the renewal period length (this is the new condition) are overridden with contract end date as limit counter period end date.
Resolution:	Plan Year limits are only overridden now: 1. when the subscription has an enddate (existing condition) 2. AND the renewal length is 1 Year. (new condition) Note: renewal length of 12 months are not overridden.
32073589	3-24368499541	NXT-21371	BP	Dynamic Logic exception: Restricted method invocation
Description:	When accessing the object returned by the JSON slurper, the application raises an exception, e.g.: Error occurred in dynamic logic "DYLO_NAME" on line "xxx": "java.lang.SecurityException: Restricted method invocation."
Resolution:	The new version of Groovy packaged with the application returns a Lazymap object from the JSON slurper. Access from Dynamic Logic to objects of this type was not permitted, this has now been changed.
32075162	3-23875773991	NXT-21373	BP	LIMITS NOT APPLIED ON OVERRIDING BENEFIT SPECIFICATIONS
Description:	If an overriding benefit specification is used on a claim line, the line applies the correct coverage regime with the correct parameters. However, any limit parameters specified on the product for the benefit specification are ignored and no limits are consumed. The expectation for the system is to count the limits specified on the product benefit specification.
Resolution:	Limits of the combination of product and overriding coverage specification will now be applied to the claims.
32113578	3-24068646251	NXT-21420	BP	Business validation error not handled correctly in UI leading to unexpected exception
Description:	When business validation added to the corresponding UI data row, exception throws and it is not handled in UI. So it navigates to the standard error page.
Resolution:	Handled the error where save logic is written. Now it will be shown in the corresponding page as the expected error. Message 'The server is unable to respond' does not show anymore when saving in the application.
32150183	3-24500949741	NXT-21466	BP	Exception occurred when user selects value to the column level multivalue flex code.
Description:	When the user selects a value from the LOV for a multivalued flex code column, null pointer exception is thrown and error page displayed.
Resolution:	A value can now be selected from the LOV for a multivalued flex code column without any error.
32173051		NXT-21504	BP	UNABLE TO NAVIGATE TO VIEW PAGE AFTER PERFORMING EDIT OPERATION
Description:	Confirmation message was not appearing after edit operation and then being redirected to view page.
Resolution:	When Edit action is performed on any HRR page and the changes are saved, the page displays the Confirmation message and gets re-directed to View mode again
31025569	3-22535876581	NXT-20300		LARGE WRITECONSUMPTIONBATCH ENCOUNTERS ORA-00054: RESOURCE BUSY AND ACQUIRE WITH NOWAIT
Description:	For WriteConsumptionBatch, we see several requests failing with error 'ORA-00054: resource busy and acquire with NOWAIT'. This happens frequently due to locking conflicts between multiple execution threads.
Resolution:	Redesign the WRITECONSUMPTIONBATCH IP to avoid locking conflicts between different threads. The import will be based on the grouping of the service member and the limit code. All the consumption of the same counter will import from a single activity. To achieve this new database table is introduced - ALI$WRITE_CONSUMPTIONS.
31837529	3-23894002141	NXT-21056		Migration set exclusions are not retained on save action
Description:	When for the migration set Exclusions are checked and the set is saved, when re-opening the set, the exclusions are not checked. Re-checking the exclusions and saving the set could solve this issue.
Resolution:	Checked exclusions are now retained when the Migration Set is saved.
32020036		NXT-21170		CMT is not implemented for Member identifiers
Description:	Missing Identifier Types in CMT
Resolution:	Identifier types are now migratable through CMT

BugDB

Internal

Summary

31973848

3-23876699351

NXT-21247

CLAIM SUBMIT API LEADS TO UNINTENDED PEND RESOLUTION

Description:

The claim submit API (meant to support the submit button in the JET Claim page) exhibits different behavior from the submit button in the ADF Claim page. Pend reasons that are not resolved should not be auto-resolved through submitting a claim.

Resolution:

The Claim Submit API no longer automatically resolves reasons in the same transaction. Pend reasons have to be resolved explicitly prior to submitting. This ensures that a user always takes notice of potential issues with a claim.

32006838

3-23723613251

NXT-21290

REFERENCE SHEET IMPORT ELEMENT DATATYPE IS NOT REGISTERED IN ALL THE NODES OF CLUSTER

Description:

Reference sheet Import element datatype is not registered in all the nodes of cluster. This issue is reproducible only in multi-nodes cluster setup.
The following steps might help to reproduce.
1. Create a new reference sheet
2. Configure the property ohi.referencesheetimport.filereader.chunk.size to 2 (default is 5000) using properties API
3. Create a data file containing ~10 reference sheet lines and import using REFSHEETLINE_IMPORT activity.

Resolution:

Reference sheet lines should be imported successfully in multi-nodes cluster setup

32032749

3-24072465081

NXT-21322

PREVENT PLAN YEAR OVERRIDE FOR NON-YEAR LIMITS

Description:

The functionality to override plan year periods (meant for plan anniversary changes) is overriding not only the actual year limits but also daily and monthly limits. This feature kick’s in when the enrollment response contains a value for the contract end date. The current system behavior is that - during calculation - any limit that uses the reference 'plan year' automatically applies a counter period based on the contract start and end date extracted from the response.

The fix is to add an additional condition to this feature that checks the configured renewal period length on a limit, so that only limits with
(1) AND a reference date equal to the plan anniversary day (this condition is already implemented)
(2) AND with a single year as the renewal period length (this is the new condition) are overridden with contract end date as limit counter period end date.

Resolution:

Plan Year limits are only overridden now:
1. when the subscription has an enddate (existing condition)
2. AND the renewal length is 1 Year. (new condition)
Note: renewal length of 12 months are not overridden.

32073589

3-24368499541

NXT-21371

Dynamic Logic exception: Restricted method invocation

Description:

When accessing the object returned by the JSON slurper, the application raises an exception, e.g.: Error occurred in dynamic logic "DYLO_NAME" on line "xxx": "java.lang.SecurityException: Restricted method invocation."

Resolution:

The new version of Groovy packaged with the application returns a Lazymap object from the JSON slurper. Access from Dynamic Logic to objects of this type was not permitted, this has now been changed.

32075162

3-23875773991

NXT-21373

LIMITS NOT APPLIED ON OVERRIDING BENEFIT SPECIFICATIONS

Description:

If an overriding benefit specification is used on a claim line, the line applies the correct coverage regime with the correct parameters. However, any limit parameters specified on the product for the benefit specification are ignored and no limits are consumed. The expectation for the system is to count the limits specified on the product benefit specification.

Resolution:

Limits of the combination of product and overriding coverage specification will now be applied to the claims.

32113578

3-24068646251

NXT-21420

Business validation error not handled correctly in UI leading to unexpected exception

Description:

When business validation added to the corresponding UI data row, exception throws and it is not handled in UI. So it navigates to the standard error page.

Resolution:

Handled the error where save logic is written. Now it will be shown in the corresponding page as the expected error. Message 'The server is unable to respond' does not show anymore when saving in the application.

32150183

3-24500949741

NXT-21466

Exception occurred when user selects value to the column level multivalue flex code.

Description:

When the user selects a value from the LOV for a multivalued flex code column, null pointer exception is thrown and error page displayed.

Resolution:

A value can now be selected from the LOV for a multivalued flex code column without any error.

32173051

NXT-21504

UNABLE TO NAVIGATE TO VIEW PAGE AFTER PERFORMING EDIT OPERATION

Description:

Confirmation message was not appearing after edit operation and then being redirected to view page.

Resolution:

When Edit action is performed on any HRR page and the changes are saved, the page displays the Confirmation message and gets re-directed to View mode again

31025569

3-22535876581

NXT-20300

LARGE WRITECONSUMPTIONBATCH ENCOUNTERS ORA-00054: RESOURCE BUSY AND ACQUIRE WITH NOWAIT

Description:

For WriteConsumptionBatch, we see several requests failing with error 'ORA-00054: resource busy and acquire with NOWAIT'. This happens frequently due to locking conflicts between multiple execution threads.

Resolution:

Redesign the WRITECONSUMPTIONBATCH IP to avoid locking conflicts between different threads. The import will be based on the grouping of the service member and the limit code. All the consumption of the same counter will import from a single activity. To achieve this new database table is introduced - ALI$WRITE_CONSUMPTIONS.

31837529

3-23894002141

NXT-21056

Migration set exclusions are not retained on save action

Description:

When for the migration set Exclusions are checked and the set is saved, when re-opening the set, the exclusions are not checked. Re-checking the exclusions and saving the set could solve this issue.

Resolution:

Checked exclusions are now retained when the Migration Set is saved.

32020036

NXT-21170

CMT is not implemented for Member identifiers

Description:

Missing Identifier Types in CMT

Resolution:

Identifier types are now migratable through CMT

Issues that were backported in previous Release / Patch

BugDB	Internal	Summary	Backport	BugDB	SR
31025569	NXT-20300	LARGE WRITECONSUMPTIONBATCH ENCOUNTERS ORA-00054: RESOURCE BUSY AND ACQUIRE WITH NOWAIT	3.19.2.0.9	31025620	3-22535876581
31837529	NXT-21056	Migration set exclusions are not retained on save action	3.20.2.0.7	31837538	3-23894002141