Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.10

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.10.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.23.1.x is only compatible with other Oracle Health Insurance applications release version 4.23.1.x unless explicitly stated otherwise.
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.
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

CPN-3079

Auto purge feature

As data volume in Oracle Health Insurance applications continue to grow with the processing of more data, it becomes essential to manage the database efficiently. Oracle Health Insurance applications include various PL/SQL packages for purging processes. However, these processes currently require manual intervention by customer DBAs/AMS team to configure and schedule purge jobs during planned maintenance windows.

To streamline this process and automate database maintenance, we are introducing an auto-purge job feature. This feature eliminates the need for manual scheduling of various purge jobs and ensures that data is regularly purged according to predefined criteria.

As part of this enhancement, we have a introduced a new PL/SQL package ohi_auto_purge_pkg.purge_all and modified the following functionalities :

  1. The structure of the following procedures has been revised, introducing an optional input parameter p_commit_size to enhance flexibility and control over the purging process

    • cla_data_purge_pkg.purge_data

    • ohi_repl_purge_pkg.purge_data

  2. Log message purging is now integrated into the auto-purge feature, and as a result, the following HTTP API resources have been made read-only.

    • logeventretentionperiods API

    • loglevelretentionperiods API

  3. Purging of PHI logs is now integrated into the auto-purge feature. So, the property ohi.logging.phi.min.retentionperiod is removed

  4. The process now integrates purging of all datafile sets into the auto-purge system, eliminating the need for separate scheduled scavenging and purging of incident files. So, the property ohi.incident.datafileset.retentionperiod is removed

Oracle recommends frequent and automatic purging of technical data and operational data using the auto-purge job feature. For example, customer DBA/AMS team (in SaaS) can set up auto purge through the use of a DBMS_SCHEDULER job. See the user guide for more details and for a sample SQL script that creates auto purge job using DBMS_SCHEDULER.create_job PL/SQL procedure.

Note that the initial purge job might take longer if the volume of the data is very high (for example, if the system has two years of data to purge and if the retention days for technical data are set to 60 days). So, Oracle recommends the DBA/AMS team to set a higher retention period (for example, one year and 11 months) for the initial run (so only 30 days of data is purged in the very first run). The retention days can be reduced gradually until the historical data is purged.

4.23.2.0.3, 4.24.1.0.0

POL-12956

Purge data files

In Oracle Health Insurance applications, data files generated during various activities (e.g., extract activity, financial messages activity and data files uploaded to initiate long-running operations) remain in the system even after they have been processed/consumed. Currently, there is no mechanism in place to automatically clean up these data files once they have been processed/consumed, leading to inefficiency of the database storage space.

This enhancement aims to automate the cleanup process and optimize database storage space. To enable purging data files, we have introduced a new PL/SQL package ohi_purge_datafileset_pkg.

4.23.2.0.3, 4.24.1.0.0

POL-15792

Optimize loading of SVNTV fields into the memory during extracts

Currently, the system loads all the Single Value Non-Time Valid(SVNTV) dynamic fields associated with resources into the memory which causes OOM. Only the required SVNTV dynamic fields should be loaded into memory while processing the extracts.

4.24.1.0.1

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

Ref Action Description

CPN-3079

Removed

ohi.logging.phi.min.retentionperiod

Purging of logs is now integrated into the auto-purge feature. So, this property is removed. The default retention for PHI logs with the auto-purge function is 2560 days (7 years) and can be managed through the autopurgemetadata API

CPN-3079

Removed

ohi.incident.datafileset.retentionperiod

Purging of all datafile sets is now integrated into the auto-purge system, hence, eliminating the need for separate scheduled scavenging and purging of incident files. So, this property is removed.

Web Services

Ref Action Description

CPN-3079

Added

autopurgemetadata API

Added a new autopurgemetadata API

CPN-3079

Removed

loglevelretentionperiods API

loglevelretentionperiods API supports only GET operation. POST/PATCH/PUT/DELETE operations are not longer supported

CPN-3079

Removed

logeventretentionperiods API

logeventretentionperiods API supports only GET operation. POST/PATCH/PUT/DELETE operations are not longer supported

Data Conversion

This section intentionally left blank.

Dynamic Logic

This section intentionally left blank.

UI Changes

This section intentionally left blank.

Breaking Changes

Ref Action Description

CPN-3079

Removed

loglevelretentionperiods API

loglevelretentionperiods support only GET operation. POST/PATCH/PUT/DELETE operations are no longer supported. So, it is not possible to purge log messages based on a specific log level. Instead purging of logs (irrespective of the log level) is now integrated into the auto-purge feature

CPN-3079

Removed

logeventretentionperiods API

logeventretentionperiods API support only GET operation. POST/PATCH/PUT/DELETE operations are no longer supported. So, it is not possible to purge log messages based on a specific log level. Instead purging of logs (irrespective of the log level) is now integrated into the auto-purge feature

Bug Fixes

BugDB SR Internal Summary

37014450

3-37140647951

NXT-30267

Retrieval access restrictions Brand/Payer missing for CtrClaims and related entities.

Description:

Retrieval access restrictions for Brand/Payer are not present in generic API. When the brand/payer is restricted, a user can still get the CtrClaim and its related entities with the API.

Resolution:

Brand and payer access restriction have been added on retrieval of a ctrclaim and its related entities such as ctrclaimLine, ctrclaimmesssage, ctrclaimlinemessage, etc. Now these records will not be accessible through API without proper access roles granted to the user.

36967429

NXT-30185

ID of single-valued flex code is returned as "null" in the generic API response

Description:

ID of single-valued flex code is returned as "null" in the generic API response.

Resolution:

ID attribute of single value flex code is now excluded from the generic API response.

36930591

3-37528423954

NXT-30093

Data points missing under claims pricing tab

Description:

Claims Pricing tab needs to be restructured with the following changes:

Description to be added under set 1 of applied provider pricing clause tab. Deeplink needs to be enabled for Type field placed under title. Provider Pricing Clause should be displayed with deeplink enabled.

Resolution:

Claims Pricing tab is restructured to display more information and deeplinks

36584496

3-36499732951

NXT-29315

Action of limit is not getting applied for Claim Line Limit for Reservation claim

Description:

Action of limit is not getting applied for Claim Line Limit for Reservation claim when arg3 in predefined method claimLine.setClaimLineLimit is null.

Resolution:

If the reached action is null, then system will search if any non null value exist for reached action ( as per priority). If a Non null value exist then that will be used for limit action (as per priority).

36531397

3-36392583761

NXT-29213

Internal system user is used for resolving the claim pends via pend resolution batch IP

Description:

When pend reasons are resolved by the pendresolutionbatch IP, internal system user is used for resolving the claim or claim line pends. This causes the IP to fail when access restricted pend reasons are resolved. Current user should be used to resolve the pends via pend resolution batch IP.

Resolution:

Instead of System User , the information of user who triggered the pend resolution batch IP will now be used for resolving the pend.

36446613

3-36208346711

NXT-29070

Query to fetch errorred tasks of a claim runs very slow

Description:

Query to fetch errorred tasks of a claim runs very slow after upgrading to 4.23.1.0.4/4.23.1.0.5 patch

Resolution:

The statistics are associated for ohi_return_collection and now the query to fetch errorred tasks runs faster

36915948

3-36983961191

NXT-30065

No base views are generated for Insurable entity and Insurable person tables

Description:

Base view generation for OHI_INSURABLE_ENTITIES and OHI_INSURABLE_PERSONS tables was disabled.

Resolution:

Base view generation for OHI_INSURABLE_ENTITIES and OHI_INSURABLE_PERSONS tables has been enabled.

37063447

NXT-30326

Nothing is showing up on click of summary button in claim line

Description:

Navigate to claims page and fetch any of the claim which has claim lines. Open any of the claim line and click on summary button.

Nothing shows up on click of summary button.

Resolution:

Claimline summary drawer opens on click of summary button in details page

37031445

3-37528423931

NXT-30281

Additional Field values when filled are not retained after save

Description:

Additional field values of a dynamic record for a claim cannot be nullified by passing in empty tags

Resolution:

Additional field values of a dynamic record for a claim can now be nullified by passing in empty tags in the PATCH payload

37337964

3-37575580501

NXT-30772

Field values are intermittently not being set when using the JET UI

Description:

An intermittent issue with setting field values in the JET UI is noticed. To reproduce Create a field, such as 'endDate', for any usage , Set a value for this field and save it , Verify if the value is reflected correctly ,Update the value and save it again. Occasionally, the updated value is not being saved properly. Specifically, the payload sent from the UI intermittently omits the updated field value

Resolution:

The value updates successfully regardless of how many times it is modified.

37183340

3-36396091781

NXT-30538

Claim fails with pricing mismatch when covered amount on claim and its lines are in different currencies

Description:

If a claim meets a benefit error during claims processing, system tries to clear previous results on claim lines. If given claim is not paid, total covered amount of claim is adjusted by considering claim lines. If claim’s currency is different from covered amount currencies on claim lines, claim’s total covered amount adjustment goes wrong.

Resolution:

During claim line cleanup, claim line which is having covered amount currency different as compared to claim’s covered amount currency is not considered for claim’s total covered amount adjustment.

36899894

3-37469586051

NXT-30012

In Adf, Draft Provider Pricing Clause Search On Procedure Group does not work

Description:

In ADF, Draft Provider Pricing Clause Search On Procedure Group Does Not Work

Resolution:

In ADF, Draft Provider Pricing Clause Search on Procedure Group is working as expected.

37110410

NXT-30437

Popuptail is Displaying Title as "Default" in All Popups Regardless of Resource

Description:

PopupTail is displaying Title as "Default" in all popups regardless of resource. "Default" is displayed for most popupTails but for certain Resources from the JET code we display them as Procedures, Providers ie ResourceName, etc(from a fixed list)

Resolution:

Popuptail displays the Title as per the resource name.

36911468

3-37575252321

NXT-30055

Financial message generation fails with ora-06502: PL/SQL: numeric or value error: number precision too large

Description:

The financial message generate step is erroring out when the fin_base_financial_objects id is greater than 14 digits as the ohi_id_code_rec_tp still has id column definition as number ( 14,0)

Resolution:

The financial message generate step works when the fin_base_financial_objects id is greater than 14 digits and less than 19 digits

37156599

NXT-30486

Activity remains in IP status as the technical flag for submission is not cleared on TE activities

Description:

The activities remain stuck in IP status as the technical flag for submission (TEC_IND_SUBMISSION) flag was not cleared for the parent activities with status TE. These TE activities occupy the entire submission bucket, the size of which is determined by the property ohi.processing.max.concurrentparentactivities.size, which has a default value of 8.

If the bucket is full, the newly submitted activity will remain in IP.

Resolution:

The query to fetch the count of currently submitted activity was modified to fix the issue.

37157421

3-36913840401

NXT-30491

Extract requests can have a limited number of characters in the condition

Description:

Extract request with a large query fails with activity message "ORA-06502: PL/SQL: numeric or value error ORA-06512: at line 1". This is because the selection is stored in a variable with a maximum of 32000 characters.

Resolution:

Selection is now stored as a clob of which the maximum size depends on environment settings: (4 GB - 1) * DB_BLOCK_SIZE initialization parameter (8 TB to 128 TB). Contact database administrator for more details if needed. This change allows for a more extensive query in the extract request and a lesser chance of running into the ORA-06502 error.

36947688

3-37168123701

NXT-30150

Clicking on File Export should download file in HTML format in ADF

Description:

Clicking on File Export should download file in HTML format in ADF.

Resolution:

When user clicks on File Export in ADF UI Page, file gets downloaded in HTML format.

37057308

NXT-30318

Remove on a Multi-value Dynamic Record is removing all the Data.

Description:

Upon adding multiple records into an implemented dynamic record on a floorplan, after adding two records, when we want to delete the first record from the already added records by clicking the remove button, it deletes all of the records and even the new record fields.

Resolution:

Remove on a Multi-value Dynamic Record removes only respective rows and not all the rows

37248605

NXT-29712

Unauthorized error while uploading file in Inbound configuration migration

Description:

401 Unauthorized error is returned while uploading file in Inbound configuration migration

Resolution:

Able to upload file without any error in Inbound configuration page

Issues that were backported in previous Release / Patch

No backports.