Release Notes for Oracle Health Insurance Claims Adjudication Patch 3.21.3.0.4

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 3.21.3.0.4.

Enhancements

ID Summary Description Included in Patch

NXT-21416

Use Vault as alternative secrets store with WebLogic deployments

Next to Fusion Middleware / WebLogic Oracle Platform Security Services (OPSS), OHI applications also support HashiCorp Vault as alternative secrets store. See the Installation Guide for details.

NXT-23140

Episode recognition: Allow overlapping episodes of same type and allow start date end date updates at inclusion

This enhancement allows for overlapping episodes for a member, episode definition, and time validity.

New attributes episode identifier is added to episode and claim line. The system matches the identifier on the claim line to the identifier on the episode to find an existing episode for a member/definition combination within the time span of the claim line. The identifier on the episode is set by function dynamic logic specified on the episode definition (new signature) which is triggered during episode creation via the claims processing.

It also allows for the episode end date to be updated at the inclusion of a claim line

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

Additional Upgrade Steps for Installation

The following phases are defined:

  1. pre-upgrade: Application is still running

  2. pre-undeploy: Application is stopped, but not undeployed.

  3. post-undeploy: Application is undeployed. Database is backed up

  4. post-upgrade: Released upgrade script has run.

  5. post-deploy: New application is deployed and is up and running.

Stage: pre-upgrade

Action: execute the following query to find future duplicates

select usrs.login_name
,      dupes.alias
from   ohi_users usrs
,      ohi_user_preferences uspr
,      (select uspr_id
        ,      alias
        from   ohi_bookmarks
        group  by uspr_id
        ,      alias
        having count(*) > 1
       ) dupes
where  uspr.id = dupes.uspr_id
and    usrs.id = uspr.usrs_id

This query lists bookmark aliases per user that have more than one occurrence and will violate the new unique contraint. Update the alias of the violations such that there are no more duplicates

Configuration Properties

Ref Action Subject Description

NXT-21416

Added

ohi.vault.clientkeypemfile.url

URL to Vault Client Key pem file

NXT-21416

Added

ohi.vault.address

Vault address. Must use HTTPS

NXT-21416

Added

ohi.vault.jkskeystore.password

Password for JKS keystore that contains certificates

NXT-21416

Added

ohi.vault.clientpemfile.url

URL to Vault Client pem file

NXT-21416

Added

ohi.secure.secrets.store

The type of store the OHI application uses for secrets

NXT-21416

Added

ohi.vault.kv.secrets.engine

By default, OHI applications assume that Vault’s Key-Value secrets engine is enabled at root path "secret"

NXT-21416

Added

ohi.vault.pemfile.url

URL to Vault pem file

NXT-21416

Added

ohi.vault.namespace

OHI specific Vault namespace section, under the path determined by properties ohi.vault.kv.secrets.engine/ohi.vault.namespace to look for secrets

NXT-21416

Added

ohi.vault.token

Vault token

NXT-21416

Added

ohi.vault.truststore.url

URL to truststore that contains certificates

NXT-21416

Added

ohi.vault.jkskeystore.url

URL to JKS keystore that contains certificates

Web Services

Ref Action Subject Description

NXT-23140

Modified

CL0155

Modified Claims In IP to allow setting of episodeIdentifier at claim line level

NXT-23140

Modified

CL0156

Modified Claims Update IP to allow setting of episodeIdentifier at claim line level

Data Conversion

This section intentionally left blank.

Dynamic Logic

Ref Action Subject Description

NXT-23140

Added

Episode Identifier

Added new dynamic logic to generate new episode identifier.

NXT-23140

Modified

Transaction Scenario (Claim Line)

Added line ctrClaimLine.episodeIdentifier=claimLine.episodeIdentifier

UI Changes

This section intentionally left blank.

Deprecated items (to be removed in future release)

This section intentionally left blank.

Breaking Changes

Ref Action Subject Description

NXT-23140

Modified

Episode (End Date)

Changed input variable name of dynamic logic signature from triggeringLine to claimLine

NXT-23140

Removed

CL0147

Removed Episode IP. Episode API can be used for same purpose now

Bug Fixes

BugDB SR Internal BP Summary

33009404

3-26178292391

NXT-22819

End benefits callout does not execute after manual benefit pend reason reason was accepted.

Description:

End benefits callout does not execute after manual benefit pend reason reason was accepted.

Resolution:

End Benefits Callout will be executed after manual benefits pend reason was accepted.

33587269

NXT-23836

BP

Boilerplate texts are not loading for some of the timestamp formats.

Description:

Boilerplate texts were not loading when provided timestamp was in different formats.

Resolution:

Fix was made to load boilerplate texts for different timestamp formats.

33641627

3-27463122071

NXT-23923

BP

Removing column URI from OHI_BOOKMARK_UK1

Description:

In 3.21.3.0.0 unique constraint OHI_BOOKMARK_UK1 was created on the combination of user preferences, alias and URI of the bookmark. The URI column should be removed from the constraint.

Resolution:

The attribute URI is removed from the Unique Key on Bookmarks.

33665412

NXT-23968

When a custom floorplan is enabled to show dynamic record as a tab, the table is not getting displayed when clicked on add button and resolve button is not showing up in claims pend reason tab.

Description:

When a custom floorplan is enabled to show dynamic record as a tab, the table is not getting displayed when clicked on add button and resolve button is not showing up in claims pend reason tab

Resolution:

User will be able to configure custom floorplans to show dynamic record as a tab.

33667830

NXT-23975

BP

Page is not getting redirected to View-Edit page after successfully creating Claim using custom floorplan

Description:

When user is having multiple floorplans available, and creates a claim using any of the floorplan, then the page is not getting redirected to view-edit page after successful creation.

Resolution:

User will be redirected to claim view-edit page upon successful creation of a new claim using any of the floorplan available.

33667835

NXT-23976

BP

Create claim is not loaded with the selected floorplan when multiple floorplans are available through Create Claim tile.

Description:

User is having multiple HRR floorplans configured for Claim page. When user tries to create a claim through "Create Claim" tile, user will be shown with available floorplans in a dropdown for choosing. For whatever selection the user makes, it will be loading only the first floorplan available in the aforementioned list.

Resolution:

User will be able to select floorplan to be shown in Claims create page.

33667849

NXT-23977

BP

Claims page is stuck after creating new claim and when multiple floorplans are available

Description:

Once after creating a claim, page gets stuck and user is not able to navigate out of the page.

Resolution:

Upon successful creation of a claim, user will be redirected to the view-edit page where user will be able to navigate out of the page.

Issues that were backported in previous Release / Patch

No backports.