Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.4

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.4.

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.

Enhancements

ID Summary Patch

ID	Summary	Patch
NXT-26997	Additional information on applied benefits This enhancement introduces additional fields on the claim page for the evaluated waiting period, whether the waiting period was served, and benefits applied as a result. This enhancement also introduces the ability to evaluate claim line parameters for a context waiting period logic for cases where a member has yet to serve the waiting period. Documentation Links: Operations Guide - Calculate Coverage and Consumption Operations Guide - Claim Line Benefit Specifications	3.22.2.0.17, 4.23.2.0.0
NXT-27054	Extend init condition evaluation for multivalued records in region/tab Support Initialization conditions (initCondition) at region/tab level for multi-values records.	3.22.2.0.17, 4.23.2.0.0
NXT-27951	Claims POST registrations API This enhancement introduces the POST operation to the registrations API resource. Documentation Links: Developer Guide	3.22.2.0.16, 4.23.2.0.0
POL-12478	Exclude reference resources for generic GET operation This enhancement introduces a new resource representation parameter excludereferenceresources. When set to `true`, it excludes the list and reference resources from the generic GET response. Additionally, for the search requests originating from UI, excludereferenceresources is set to `true`, that is, to retrieve only the required details. Documentation Links: Developer Guide - Exclude reference resources	3.22.2.0.17, 4.23.2.0.0
POL-12778	Extracts: Decouple bucket size from fetch size When an extract is executed, the system creates a Global Activity. This activity is spawns Child Activities that each fetch a certain amount of entities and stores them in a Data File. The number of fetched entities per child activity (noted as 'X') is determined by a system property, ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS. All those fetched entities are stored in the same Data File. Therefore, the fetch size equals the Data File size. When all the entities are meant to be gathered in a single Data File the system property will be set to a high value, which can cause memory issues when the same number of entities and subresources is fetched in memory. With this enhancement, we decouple the fetch size from the data file size.
POL-13467	*Improvements on the persons* page** This enhancement introduces a new object navigation link on the persons page to maintain person covered services.	3.22.2.0.17, 4.23.2.0.0
POL-14103	Ability to access PII in base views By default, the base views exclude all columns and dynamic fields that contain Personally Identifiable Information (PII). This enhancement introduces a system property that overrides this behavior, so that PII data elements become available in base views. This feature enables customers to use base views to create reports that contain PII.	4.23.2.0.0

NXT-26997

Additional information on applied benefits

This enhancement introduces additional fields on the claim page for the evaluated waiting period, whether the waiting period was served, and benefits applied as a result.

This enhancement also introduces the ability to evaluate claim line parameters for a context waiting period logic for cases where a member has yet to serve the waiting period.

Documentation Links:
Operations Guide - Calculate Coverage and Consumption
Operations Guide - Claim Line Benefit Specifications

3.22.2.0.17, 4.23.2.0.0

NXT-27054

Extend init condition evaluation for multivalued records in region/tab

Support Initialization conditions (initCondition) at region/tab level for multi-values records.

3.22.2.0.17, 4.23.2.0.0

NXT-27951

Claims POST registrations API

This enhancement introduces the POST operation to the registrations API resource.

Documentation Links:
Developer Guide

3.22.2.0.16, 4.23.2.0.0

POL-12478

Exclude reference resources for generic GET operation

This enhancement introduces a new resource representation parameter excludereferenceresources. When set to true, it excludes the list and reference resources from the generic GET response.

Additionally, for the search requests originating from UI, excludereferenceresources is set to true, that is, to retrieve only the required details.

Documentation Links:
Developer Guide - Exclude reference resources

3.22.2.0.17, 4.23.2.0.0

POL-12778

Extracts: Decouple bucket size from fetch size

When an extract is executed, the system creates a Global Activity. This activity is spawns Child Activities that each fetch a certain amount of entities and stores them in a Data File. The number of fetched entities per child activity (noted as 'X') is determined by a system property, ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS. All those fetched entities are stored in the same Data File. Therefore, the fetch size equals the Data File size. When all the entities are meant to be gathered in a single Data File the system property will be set to a high value, which can cause memory issues when the same number of entities and subresources is fetched in memory. With this enhancement, we decouple the fetch size from the data file size.

POL-13467

Improvements on the persons page

This enhancement introduces a new object navigation link on the persons page to maintain person covered services.

3.22.2.0.17, 4.23.2.0.0

POL-14103

Ability to access PII in base views

By default, the base views exclude all columns and dynamic fields that contain Personally Identifiable Information (PII). This enhancement introduces a system property that overrides this behavior, so that PII data elements become available in base views. This feature enables customers to use base views to create reports that contain PII.

4.23.2.0.0

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

Additional Upgrade Steps for Installation

The following phases are defined:

pre-upgrade: Application is still running
pre-undeploy: Application is stopped, but not undeployed.
post-undeploy: Application is undeployed. Database is backed up
post-upgrade: Released upgrade script has run.
post-deploy: New application is deployed and is up and running.

Stage: post-upgrade

Action: Applicable for SaaS deployments/AMS team: configure property "ohi.baseview.exclude.pii" in the property file and set the property value to "true". This property when set to false will allow the end user to access PII data in baseviews. In case SaaS customer wants to flip value of property then they need to raise ticket to AMS team.

Configuration Properties

Ref	Action	Description
POL-12778	Added	ohi.extract.datafilesize.{0} This property controls how many items are gathered in a single Data File of a specific entity.
POL-12778	Added	ohi.extract.datafilesize This property controls how many items are gathered in a single Data File. We suggest a value between 1 and 1000.
POL-12778	Removed	ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS
POL-14103	Added	ohi.baseview.exclude.pii This new boolean property controls whether Personally Identifiable Information (PII) is included in base views. By default, PII is excluded from base views. SaaS customers can change the value of this property by submitting a service request.

Ref

Action

Description

POL-12778

Added

ohi.extract.datafilesize.{0}

This property controls how many items are gathered in a single Data File of a specific entity.

POL-12778

Added

ohi.extract.datafilesize

This property controls how many items are gathered in a single Data File. We suggest a value between 1 and 1000.

POL-12778

Removed

ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS

POL-14103

Added

ohi.baseview.exclude.pii

This new boolean property controls whether Personally Identifiable Information (PII) is included in base views. By default, PII is excluded from base views. SaaS customers can change the value of this property by submitting a service request.

Web Services

Ref	Action	Description
NXT-26997	Modified	Claim Line Benefit Specifications API Created the attribute evaluationResult
NXT-26997	Modified	Ctr Claim Line Benefit Specifications API Created the attribute evaluationResult
NXT-27951	Modified	registrations API User can now create and update registrations through generic API

Ref

Action

Description

NXT-26997

Modified

Claim Line Benefit Specifications API

Created the attribute evaluationResult

NXT-26997

Modified

Ctr Claim Line Benefit Specifications API

Created the attribute evaluationResult

NXT-27951

Modified

registrations API

User can now create and update registrations through generic API

Data Conversion

This section intentionally left blank.

Dynamic Logic

This section intentionally left blank.

UI Changes

Ref	Action	Description
NXT-26997	Modified	Claims Page The regime evaluation result is added to the applied benefits section of the page. Also, the applied parameters show the actual values that were applied
NXT-27054	Added	Applicable to any page configured with init condition InitCondition should support for Multi-value records when added in Region/Table.
POL-13467	Modified	Persons Removed covered services tab from the persons floorplan. Added Person covered services as an object navigation

Ref

Action

Description

NXT-26997

Modified

Claims Page

The regime evaluation result is added to the applied benefits section of the page. Also, the applied parameters show the actual values that were applied

NXT-27054

Added

Applicable to any page configured with init condition

InitCondition should support for Multi-value records when added in Region/Table.

POL-13467

Modified

Persons

Removed covered services tab from the persons floorplan. Added Person covered services as an object navigation

Breaking Changes

Ref	Action	Description
POL-13467	Modified	Persons It is not allowed to re-configure person covered services as a tab on the persons page, as they are now available as a separate object navigation page.

Ref

Action

Description

POL-13467

Modified

Persons

It is not allowed to re-configure person covered services as a tab on the persons page, as they are now available as a separate object navigation page.

Bug Fixes

BugDB	SR	Internal	Summary
36251071	3-28606893871,3-35610906861	NXT-28660	Enrollment callouts throw a null pointer error on the read timeout
Description:	Enrollment callouts should not throw a null pointer exception on read timeout. It should log the timed out message and throw EnrollmentClientException.
Resolution:	In the occurrence of a timeout, the timed out message is logged and an exception is thrown.
35722678		NXT-27519	Generate baseviews fails intermittently with CacheCreationException
Description:	Generate baseviews fails intermittently with CacheCreationException: Name of the cache entityNamePropertyCache already exists.
Resolution:
36203944	3-34786906091	NXT-28541	Dynamic logic byte code is not loaded during server startup on non master nodes after invalidateall IP is invoked
Description:	Dynamic logic byte code is expected to load at the startup of non-master nodes if the invalidateall API was invoked in master node but was not being observed.
Resolution:	Dynamic logic byte code is now loaded at the startup of non-master nodes if the invalidateall API was invoked in master node.
36261010	3-35639469161	NXT-28668	Changes are not saved for the code and description of an existing CMT Set in Jet UI
Description:	When changing the code and description of an existing CMT Set in JET UI the message 'Changes are saved successfully' appears but the changes are not stored.
Resolution:	Code, Description can be updated for an existing CMT Set and changes are saved successfully
36300654	3-34786906091	NXT-28750	Claim takes more time from INITIAL to PRICING DONE if one or more claim lines are denied
Description:	Claim takes more time from INITIAL to PRICING DONE if one or more claim lines are denied
Resolution:	When claim lines are denied, claim line rule coverages that are created initially are removed later on, which was causing OptimisticLockingException. This resulted in the entire claim flow to be processed twice. This is optimized now.
36285017	3-35695968321	NXT-28719	Dynamic field value is getting wiped off and not holding the data upon save and also title is not displayed
Description:	When a dynamic field is of string type, converted to Lov field and attached to Dynamic record and used as a detail page, the value selected is not retained on the page, also, when that field is used to display title of the page, the title is not displayed.
Resolution:	The selected value from LOV is retained and page is saved, also the selected value is displayed in title of the page
36246699	3-35589722501	NXT-28648	"Next" and "Previous" link on claim line detail page isn’t functional.
Description:	Open a claim which has multiple claim lines. Open any claim line and from the detail page, try to click on "Next" or "Previous" link. Nothing happens which clicking on the links.
Resolution:	Navigation works fine in claimlines detail page with "Next" and "Previous" links
36210574	3-35499768621	NXT-28561	Length of OHI_ID_ARRAY database type is still 14 after upgrading to 4.23.1 release
Description:	Length of OHI_ID_ARRAY database type is still 14 after upgrading to 4.23.1 release
Resolution:	The length of OHI_ID_ARRAY database type is updated to 19
35878081	3-34410216941	NXT-27810	Non-selective criteria in reference objects cause OHI to load too many objects in memory.
Description:	Non-selective criteria in reference objects cause OHI to load too many objects in memory.
Resolution:	Non-selective criteria in reference objects now only load two objects in the memory, which will not cause the memory protector to kick in.
35825929	3-33232690791	NXT-27737	Applied benefits are not visible against claimlines
Description:	In the Enrollment response, if there is more than one product(previous product), the claim line is approved with 0 covered amount, and applied benefits are not shown against claimlines.
Resolution:	Issue occurred since regime specification had a previous product (past/expired one). Hence now the condition has been added to check if regime specification product id is same as existing product Id.

BugDB

Internal

Summary

36251071

3-28606893871,3-35610906861

NXT-28660

Enrollment callouts throw a null pointer error on the read timeout

Description:

Enrollment callouts should not throw a null pointer exception on read timeout. It should log the timed out message and throw EnrollmentClientException.

Resolution:

In the occurrence of a timeout, the timed out message is logged and an exception is thrown.

35722678

NXT-27519

Generate baseviews fails intermittently with CacheCreationException

Description:

Generate baseviews fails intermittently with CacheCreationException: Name of the cache entityNamePropertyCache already exists.

Resolution:

36203944

3-34786906091

NXT-28541

Dynamic logic byte code is not loaded during server startup on non master nodes after invalidateall IP is invoked

Description:

Dynamic logic byte code is expected to load at the startup of non-master nodes if the invalidateall API was invoked in master node but was not being observed.

Resolution:

Dynamic logic byte code is now loaded at the startup of non-master nodes if the invalidateall API was invoked in master node.

36261010

3-35639469161

NXT-28668

Changes are not saved for the code and description of an existing CMT Set in Jet UI

Description:

When changing the code and description of an existing CMT Set in JET UI the message 'Changes are saved successfully' appears but the changes are not stored.

Resolution:

Code, Description can be updated for an existing CMT Set and changes are saved successfully

36300654

3-34786906091

NXT-28750

Claim takes more time from INITIAL to PRICING DONE if one or more claim lines are denied

Description:

Claim takes more time from INITIAL to PRICING DONE if one or more claim lines are denied

Resolution:

When claim lines are denied, claim line rule coverages that are created initially are removed later on, which was causing OptimisticLockingException. This resulted in the entire claim flow to be processed twice. This is optimized now.

36285017

3-35695968321

NXT-28719

Dynamic field value is getting wiped off and not holding the data upon save and also title is not displayed

Description:

When a dynamic field is of string type, converted to Lov field and attached to Dynamic record and used as a detail page, the value selected is not retained on the page, also, when that field is used to display title of the page, the title is not displayed.

Resolution:

The selected value from LOV is retained and page is saved, also the selected value is displayed in title of the page

36246699

3-35589722501

NXT-28648

"Next" and "Previous" link on claim line detail page isn’t functional.

Description:

Open a claim which has multiple claim lines. Open any claim line and from the detail page, try to click on "Next" or "Previous" link. Nothing happens which clicking on the links.

Resolution:

Navigation works fine in claimlines detail page with "Next" and "Previous" links

36210574

3-35499768621

NXT-28561

Length of OHI_ID_ARRAY database type is still 14 after upgrading to 4.23.1 release

Description:

Length of OHI_ID_ARRAY database type is still 14 after upgrading to 4.23.1 release

Resolution:

The length of OHI_ID_ARRAY database type is updated to 19

35878081

3-34410216941

NXT-27810

Non-selective criteria in reference objects cause OHI to load too many objects in memory.

Description:

Non-selective criteria in reference objects cause OHI to load too many objects in memory.

Resolution:

Non-selective criteria in reference objects now only load two objects in the memory, which will not cause the memory protector to kick in.

35825929

3-33232690791

NXT-27737

Applied benefits are not visible against claimlines

Description:

In the Enrollment response, if there is more than one product(previous product), the claim line is approved with 0 covered amount, and applied benefits are not shown against claimlines.

Resolution:

Issue occurred since regime specification had a previous product (past/expired one). Hence now the condition has been added to check if regime specification product id is same as existing product Id.

Issues that were backported in previous Release / Patch

No backports.