Release Notes for Oracle Health Insurance Claims Adjudication Patch 3.22.1.0.8

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 3.22.1.0.8.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 3.22.1.x is only compatible with other Oracle Health Insurance applications release version 3.22.1.x unless explicitly stated otherwise.

OHI applications expose the technical ID (created by sequence generator) in HTTP API and IP. This might be changed to an alternate technical ID (the data type might not be an integer) in a future release. Hence, it is advised to follow the generated HATEOAS links instead of hard-coding/bookmarking the IDs in the external integrations.

In accordance with the OHI error correction policy (Document 1494031.1 on My Oracle Support), error correction support will be provided for this release and the previous two releases.

Enhancements

ID	Summary	Patch
NXT-25547	Episode Recognition for claim lines with unspecified Episode Identifiers This enhancement allows for unspecified claim line identifier as long as a unique non-void episode for the eligible episode definition, the member and which overlaps in the time validity with the claim line exists. The line gets included in the episode if it satisfies the trigger/include criteria given by the episode definition. The claim line with the identifier gets included in the episode only if the claim line identifier matches the episode identifier (in addition to the criteria match).	3.22.2.0.0

Summary

Patch

NXT-25547

Episode Recognition for claim lines with unspecified Episode Identifiers

This enhancement allows for unspecified claim line identifier as long as a unique non-void episode for the eligible episode definition, the member and which overlaps in the time validity with the claim line exists. The line gets included in the episode if it satisfies the trigger/include criteria given by the episode definition.

The claim line with the identifier gets included in the episode only if the claim line identifier matches the episode identifier (in addition to the criteria match).

3.22.2.0.0

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

Stage: pre-upgrade

Note: OHI delivers the new field N1202 with this patch. If record with the code N1202 found in the table cod_fields_b then below script will update the id with the new Id 169150 and its reference in the tables cod_flex_code_field_usages_b and cod_dynamic_field_usages_b.

It is recommended to take the DB backup before running the script.

Please execute the SQL statement with user: OHI_CLAIMS_OWNER.

declare
      l_cod_field_id cod_fields_b.id%type;
begin
      select id into l_cod_field_id from cod_fields_b where code='N1202';
      DBMS_OUTPUT.PUT_LINE ('Updating the id ' || l_cod_field_id || ' of table cod_fields_b for code N1202');
      execute immediate 'alter table cod_fields_tl disable constraint cod_field_tl_fk1';
      execute immediate 'alter table cod_flex_code_field_usages_b disable constraint cod_flex_code_field_use_fk3';
      execute immediate 'alter table cod_dynamic_field_usages_b disable constraint cod_dynamic_field_usage_fk1';
      update cod_fields_b set id = 169150 where id = l_cod_field_id;
      update cod_fields_tl set base_table_id = 169150 where base_table_id = l_cod_field_id;
      update cod_flex_code_field_usages_b set fiel_id = 169150 where fiel_id = l_cod_field_id;
      update cod_dynamic_field_usages_b set fiel_id = 169150 where fiel_id = l_cod_field_id;
      commit;
      execute immediate 'alter table cod_fields_tl enable constraint cod_field_tl_fk1';
      execute immediate 'alter table cod_flex_code_field_usages_b enable constraint cod_flex_code_field_use_fk3';
      execute immediate 'alter table cod_dynamic_field_usages_b enable constraint cod_dynamic_field_usage_fk1';
exception
      when no_data_found then
      DBMS_OUTPUT.PUT_LINE ('Update of the seed data id is skipped as no matching record was found. Please proceed with further upgrade step');
end;
/

Configuration Properties

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Web Services

Ref	Action	Description
NXT-25547	Modified	Episode generic API If episodeIdentifier isn’t passed in /generic/episodes API http request, episodeIdentifier is set to episode ID

Ref

Action

Description

NXT-25547

Modified

Episode generic API

If episodeIdentifier isn’t passed in /generic/episodes API http request, episodeIdentifier is set to episode ID

Data Conversion

Ref	Action	Description
NXT-25547	Added	Data conversion of Episode Identifier In CLA_EPISODES table, null EPISODE_IDENTIFIER is set to ID

Ref

Action

Description

NXT-25547

Added

Data conversion of Episode Identifier

In CLA_EPISODES table, null EPISODE_IDENTIFIER is set to ID

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

Ref	Action	Description
NXT-25547	Modified	episodeIdentifier is mandatory In Episode, episodeIdentifier is mandatory. If not provided, automatically set to episode id

Ref

Action

Description

NXT-25547

Modified

episodeIdentifier is mandatory

In Episode, episodeIdentifier is mandatory. If not provided, automatically set to episode id

Bug Fixes

BugDB	SR	Internal	BP	Summary
34838360		NXT-25874		Some activities are stuck in 'in process' status if new nodes are started while the activities are running
Description:	Some activities are stuck in 'In Process' status if new nodes are started while the activities are running The fix for this issue will prevent NPEs from being thrown by oracle coherence
Resolution:	Added check on startup service, so that the system starts only when fully initialized
34747033	3-31049172121	NXT-25641	BP	Error while processing a claim in manual benefits status from postman
Description:	While processing a claim, 'IllegalArgumentException: AddMessage function unavailable in the current context' error is raised on derivation rule dynamic logic execution if dynamic logic calls addMessage predefined method internally.
Resolution:	Added message context before executing derivation rule.
34619109		NXT-25435		SortBy And Create Button Alignment Issue On Claims Page
Description:	Alignment issue seen in Sort By and Create Button on claims page
Resolution:	Alignment of Buttons adjusted between Sort By and Create Button in Claims JET screen
34768417	3-30452029991	NXT-25675	BP	Limit from product benefit specification is not selected on recalculation of coverage from manual benefits.
Description:	Limit from product benefit specification is not selected on recalculation of coverage from manual benefits .
Resolution:	Now this will be resolved. We are adding the limits during recalculation and limit consumptions are updated accordingly .
34721623	3-30270443091	NXT-25585	BP	Table stats for pri$fee_schedule_lines is gathered for all child activities concurrently
Description:	Table stats for pri$fee_schedule_lines is gathered for all child activities concurrently .
Resolution:	Gather table stats once for all the child activities .
34791410	3-31111589651	NXT-25726	BP	Not able to search with criteria in case the list of value have more than 50 results
Description:	Only the first 50 results are showing for an advanced search criterion and, because of that, a user is not able to find the required flex code definition to search on procedures/providers/diagnoses pages.
Resolution:	More than 50 results are shown for Flex Code Definitions in LOV in procedures, diagnosis pages.
34650872	3-30727204301	NXT-25489	BP	Custom lov poceduregroupdetails is not working in claimlines page
Description:	Create a record definition (ex: medication) with record-fields (medicationName, otherMedication of type char-100). Create ProcedureGroupDetailsLOV floorplan with title property Procedure.descr3. Use the record field medicationName as LOV on proceduregroupdetails. It is not saving the medication name
Resolution:	The dynamic record usage values are saved and works as expected when it is configured as LOV on proceduregroupdetails
34826798	3-31306279371	NXT-25851	BP	Resources cannot be searched, when the code starts with 25
Description:	For resources having code starting with 25, when we try to search for these resources in the Jet UI, the search never gets completed. When checking the console, the API call is returning a 400 Bad request as a status.
Resolution:	Users can now perform a search for resources with query like('25%')
34813545		NXT-25803	BP	Clear deserialization errors observed in OHI application logs
Description:	OHI application logs show a lot of deserialization errors . This has no functional impact .
Resolution:	OHI application logs will not have these deserialization errors now.

BugDB

Internal

Summary

34838360

NXT-25874

Some activities are stuck in 'in process' status if new nodes are started while the activities are running

Description:

Some activities are stuck in 'In Process' status if new nodes are started while the activities are running

The fix for this issue will prevent NPEs from being thrown by oracle coherence

Resolution:

Added check on startup service, so that the system starts only when fully initialized

34747033

3-31049172121

NXT-25641

Error while processing a claim in manual benefits status from postman

Description:

While processing a claim, 'IllegalArgumentException: AddMessage function unavailable in the current context' error is raised on derivation rule dynamic logic execution if dynamic logic calls addMessage predefined method internally.

Resolution:

Added message context before executing derivation rule.

34619109

NXT-25435

SortBy And Create Button Alignment Issue On Claims Page

Description:

Alignment issue seen in Sort By and Create Button on claims page

Resolution:

Alignment of Buttons adjusted between Sort By and Create Button in Claims JET screen

34768417

3-30452029991

NXT-25675

Limit from product benefit specification is not selected on recalculation of coverage from manual benefits.

Description:

Limit from product benefit specification is not selected on recalculation of coverage from manual benefits .

Resolution:

Now this will be resolved. We are adding the limits during recalculation and limit consumptions are updated accordingly .

34721623

3-30270443091

NXT-25585

Table stats for pri$fee_schedule_lines is gathered for all child activities concurrently

Description:

Table stats for pri$fee_schedule_lines is gathered for all child activities concurrently .

Resolution:

Gather table stats once for all the child activities .

34791410

3-31111589651

NXT-25726

Not able to search with criteria in case the list of value have more than 50 results

Description:

Only the first 50 results are showing for an advanced search criterion and, because of that, a user is not able to find the required flex code definition to search on procedures/providers/diagnoses pages.

Resolution:

More than 50 results are shown for Flex Code Definitions in LOV in procedures, diagnosis pages.

34650872

3-30727204301

NXT-25489

Custom lov poceduregroupdetails is not working in claimlines page

Description:

Create a record definition (ex: medication) with record-fields (medicationName, otherMedication of type char-100). Create ProcedureGroupDetailsLOV floorplan with title property Procedure.descr3. Use the record field medicationName as LOV on proceduregroupdetails. It is not saving the medication name

Resolution:

The dynamic record usage values are saved and works as expected when it is configured as LOV on proceduregroupdetails

34826798

3-31306279371

NXT-25851

Resources cannot be searched, when the code starts with 25

Description:

For resources having code starting with 25, when we try to search for these resources in the Jet UI, the search never gets completed. When checking the console, the API call is returning a 400 Bad request as a status.

Resolution:

Users can now perform a search for resources with query like('25%')

34813545

NXT-25803

Clear deserialization errors observed in OHI application logs

Description:

OHI application logs show a lot of deserialization errors . This has no functional impact .

Resolution:

OHI application logs will not have these deserialization errors now.

Issues that were backported in previous Release / Patch

No backports.