Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.8

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.1.0.8.

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-24066	WebLogic authentication implemented compliant with the Java Authorization and Authentication Service (JAAS) specification This enhancement introduces support for the SAML 2.0 authentication mechanism in the Oracle Health Insurance. Additionally, a new JAR file named "CustomIdentityAsserter" has been created to accommodate the Basic Auth configuration. However, this feature will only be supported with the JET screens. Refer installation guide for further detail. Documentation Links: Installation Guide - Users and Authentication
NXT-27561	Selective financial limit carryover This enhancement introduces the ability to decide whether an out-of-pocket-maximum (OOPM) limit consumption counts towards year-end carryover. For example: * An OOPM consumption from a coinsurance or a copay do not count towards a carryover. * An OOPM consumption from a deductible does count towards a carryover. A new indicator, `exclude from carry over` is introduced on the product-benefit-specification limit to help make this decision. The decision acts as input to evaluate a coverage regime. Documentation Links: Configuration Guide - Adjudication Limits Configuration Guide - Product Benefit Specification Limit	4.23.1.0.5
NXT-28465	Optimize REST graph recreation of reference sheet line when a new reference sheet is created To optimise the memory load while recreating Rest Graph for Reference Sheet Line when a Reference Sheet creates every time, some java files are modified as per flow and few java files are deleted. One index has been added with respect to column TEC_ELEMENT_CODE in table OHI_REFERENCE_SHEETS Slices which were involved in this enhancement are common, datafileprocessing, referencesheets. There are multiple scenarios through which ReferenceSheetLine(s) is/are created. * Bulk upload of data file set using import activity * Generic collection patch api * Create Reference Sheet Line through Generic API & ReferenceSheetLines IP. Functionality has remain same. Only improvement is done in the perspective of memory optimisation.
NXT-29119	Claims page performance improvements. Optimize the loading time of the claims page to improve overall performance. The load time of the claims page is improved by reducing the response sizes of requested data, parallelization of data calls and deferring unused calls.
NXT-29163	Add logging to diagnose duplicate policy products issue in enrollment callout In Oracle Health Insurance Claims Adjudication and Pricing we are adding logging to capture the unique key violation and log the enrollment response received, to diagnose duplicate policy products issue in enrollment callout. The log message contains the enrollment response received and logs it to the file only in case while processing the enrollment response a unique key violation occurs.
POL-14132	Clearance of activities stuck in In Process stage from coherence submission caches using IP Due to excessive load, the processing-pattern grid service stops processing activities, causing them to be stuck in the in process stage for a long time. Manually marking these activities to technical error (TE) and resubmitting them results in an exception as a reference to these activities already exist in coherence submission caches. Thus, the recovery of activities is only possible upon a full restart. The new integration point supports the clearance of coherence submission caches to facilitate the activity recovery process to avoid a complete restart.

NXT-24066

WebLogic authentication implemented compliant with the Java Authorization and Authentication Service (JAAS) specification

This enhancement introduces support for the SAML 2.0 authentication mechanism in the Oracle Health Insurance. Additionally, a new JAR file named "CustomIdentityAsserter" has been created to accommodate the Basic Auth configuration.

However, this feature will only be supported with the JET screens.

Refer installation guide for further detail.

Documentation Links:
Installation Guide - Users and Authentication

NXT-27561

Selective financial limit carryover

This enhancement introduces the ability to decide whether an out-of-pocket-maximum (OOPM) limit consumption counts towards year-end carryover. For example: * An OOPM consumption from a coinsurance or a copay do not count towards a carryover. * An OOPM consumption from a deductible does count towards a carryover.

A new indicator, exclude from carry over is introduced on the product-benefit-specification limit to help make this decision. The decision acts as input to evaluate a coverage regime.

Documentation Links:
Configuration Guide - Adjudication Limits
Configuration Guide - Product Benefit Specification Limit

4.23.1.0.5

NXT-28465

Optimize REST graph recreation of reference sheet line when a new reference sheet is created

To optimise the memory load while recreating Rest Graph for Reference Sheet Line when a Reference Sheet creates every time, some java files are modified as per flow and few java files are deleted. One index has been added with respect to column TEC_ELEMENT_CODE in table OHI_REFERENCE_SHEETS

Slices which were involved in this enhancement are common, datafileprocessing, referencesheets.

There are multiple scenarios through which ReferenceSheetLine(s) is/are created. * Bulk upload of data file set using import activity * Generic collection patch api * Create Reference Sheet Line through Generic API & ReferenceSheetLines IP.

Functionality has remain same. Only improvement is done in the perspective of memory optimisation.

NXT-29119

Claims page performance improvements.

Optimize the loading time of the claims page to improve overall performance. The load time of the claims page is improved by reducing the response sizes of requested data, parallelization of data calls and deferring unused calls.

NXT-29163

Add logging to diagnose duplicate policy products issue in enrollment callout

In Oracle Health Insurance Claims Adjudication and Pricing we are adding logging to capture the unique key violation and log the enrollment response received, to diagnose duplicate policy products issue in enrollment callout.

The log message contains the enrollment response received and logs it to the file only in case while processing the enrollment response a unique key violation occurs.

POL-14132

Clearance of activities stuck in In Process stage from coherence submission caches using IP

Due to excessive load, the processing-pattern grid service stops processing activities, causing them to be stuck in the in process stage for a long time. Manually marking these activities to technical error (TE) and resubmitting them results in an exception as a reference to these activities already exist in coherence submission caches. Thus, the recovery of activities is only possible upon a full restart. The new integration point supports the clearance of coherence submission caches to facilitate the activity recovery process to avoid a complete restart.

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

This section intentionally left blank.

Web Services

Ref	Action	Description
NXT-27561	Modified	Product Benefit Specification Integration Point Added Exclude From Carry Over indicator on product benefit specification limits
POL-14132	Added	clearsubmissioncaches IP New IP to clear coherence submission caches.

Ref

Action

Description

NXT-27561

Modified

Product Benefit Specification Integration Point

Added Exclude From Carry Over indicator on product benefit specification limits

POL-14132

Added

clearsubmissioncaches IP

New IP to clear coherence submission caches.

Data Conversion

Ref	Action	Description
NXT-27561	Added	Product Benefit Specification Limit Exclude From Carry Over indicator set to false

Ref

Action

Description

NXT-27561

Added

Product Benefit Specification Limit

Exclude From Carry Over indicator set to false

Dynamic Logic

This section intentionally left blank.

UI Changes

Ref	Action	Description
NXT-27561	Modified	ADF Setup product benefit specifications Added Exclude From Carry Over indicator
NXT-27561	Modified	JET Setup Product Benefit Specifications Added Exclude From Carry Over indicator
NXT-29119	Modified	Pend reason flow Resolving a pend reason on claims disables or hides respective resolve links and avoids reload of the claim page.

Ref

Action

Description

NXT-27561

Modified

ADF Setup product benefit specifications

Added Exclude From Carry Over indicator

NXT-27561

Modified

JET Setup Product Benefit Specifications

Added Exclude From Carry Over indicator

NXT-29119

Modified

Pend reason flow

Resolving a pend reason on claims disables or hides respective resolve links and avoids reload of the claim page.

Breaking Changes

Ref	Action	Description
NXT-24066	Modified	Installation Configuration Customers using the Basic Authentication mechanism must follow the installation guide to install the newly built JAR file, "CustomIdentityAsserter.jar," and configure the WebLogic security provider accordingly.

Ref

Action

Description

NXT-24066

Modified

Installation Configuration

Customers using the Basic Authentication mechanism must follow the installation guide to install the newly built JAR file, "CustomIdentityAsserter.jar," and configure the WebLogic security provider accordingly.

Bug Fixes

BugDB	SR	Internal	Summary
36562893	3-34871101921	NXT-29273	Invoking exchange with filename containing diacritics corrupts created datafile name
Description:	Invoking exchange with file upload, where the filename contains diacritics, erroneously transforms the filename to some other characters.
Resolution:	By incorporating standard encoding for UTF-8 and ISO_8859-1 in multiform requests, filename with diacritics is not getting corrupted.
36718881	3-36247582081,3-36912613781	NXT-29550	NEQ query operator & boilerplate issue in claims search page
Description:	NEQ query operator not working in advanced search. "queryOperator":"neq" is not working and have incorrect boilerplate text
Resolution:	Added support for neq for all datatypes in advance search
36079076	3-35014512371	NXT-28208	External consumption on sublimit does not create counter period for its composite limit
Description:	As per current OHI behaviour, when an external consumption creates a counter period for an annual or calendar year sub limit counter, it does not create a corresponding counter period for the composite limit. Only the consumption is added to the composite limit counter.
Resolution:	Counter periods are now created for composite limits as well
36515179	3-36366863461	NXT-29189	Evaluate condition not working on dynamic records in create mode
Description:	The evaluate condition is not working on dynamic records during create mode, but it works in view and edit mode.
Resolution:	Evaluate condition can be configured on dynamic records as well and it works fine in create and view-edit mode
36654284	3-36452370811	NXT-29426	Advanced search lov’s for dynamic fields are not loading in referencesheetlines
Description:	Not able to search using the LOV’s in the reference sheet lines page. When clicking in the LOV field an error occurs on the api/generic/flexcodes/search.
Resolution:	Proper results are displayed in the LOV for flexcodes based on diagnosis, procedures and providers, displays
36393319	3-35684326321	NXT-28973	Data from technical table is not cleaned up if an extract activity fails which leads to data accumulation
Description:	Data from technical tables were only getting cleaned for activities in 'CO' status. Which was causing accumulation of huge data.
Resolution:	Along with status 'CO' all other statuses except 'IN', 'IP' and 'QD' are now included as part of cleaning process. This ensures a more cleaner technical table, hence overcoming the issue of data accumulation
36492014	3-36178158771	NXT-29146	PII data is not correctly populated when setting corresponding property
Description:	PII data is filled in as NULL when setting property "ohi.baseview.exclude.pii" to false, even though they are not null. This is only the case for entities where certain attributes are PII if the entity is of a certain subtype, e.g. for Relation of subtype 'PERS', the code column is seen as PII. When the "ohi.baseview.exclude.pii" property is set to false, this data should be seen.
Resolution:	PII data is now correctly populated when setting property "ohi.baseview.exclude.pii" to false.
36593627		NXT-29327	Remove the usage of utl_tcp DBMS package in extract functionality
Description:	Using utl_tcp DBMS package requires explicit grant in SaaS environments. This has operational challenges as the grants that are explicitly granted are periodically revoked by DBA as part of a scheduled process
Resolution:	Removed the usage of utl_tcp DBMS package in extract functionality and replaced it with a standard DB function
36568724	3-36557573371	NXT-29292	Context condition in fee schedulelines floorplan doesn’t work
Description:	When we add a condition to the feeschedulelines floorplan by referencing an attribute of the feeschedule object it always returns null in the value
Resolution:	When we add a condition to the feeschedulelines floorplan by referencing an attribute of the feeschedule object it is loading as expected. The format to give condition in floorplan should be (context.)
36619054	3-36759433791	NXT-29383	Conditional evaluation is not working on primitive type LOV fields
Description:	Conditional evaluation is not working on primitive-type LOV fields while referencing any of the properties of lov selected.
Resolution:	Conditional evaluation is working on primitive type LOV fields.To enable field1 to have the entire context of the selected LOV value, we add a new attribute to the entity (context of the parent resource). This new attribute will be named 'name_of_FieldObj'. For the example above, it will be 'field1Obj', which will contain the entire context of the selected LOV value. This allows us to conditionally evaluate various scenarios by accessing context.field1Obj.code, and other similar fields.

BugDB

Internal

Summary

36562893

3-34871101921

NXT-29273

Invoking exchange with filename containing diacritics corrupts created datafile name

Description:

Invoking exchange with file upload, where the filename contains diacritics, erroneously transforms the filename to some other characters.

Resolution:

By incorporating standard encoding for UTF-8 and ISO_8859-1 in multiform requests, filename with diacritics is not getting corrupted.

36718881

3-36247582081,3-36912613781

NXT-29550

NEQ query operator & boilerplate issue in claims search page

Description:

NEQ query operator not working in advanced search. "queryOperator":"neq" is not working and have incorrect boilerplate text

Resolution:

Added support for neq for all datatypes in advance search

36079076

3-35014512371

NXT-28208

External consumption on sublimit does not create counter period for its composite limit

Description:

As per current OHI behaviour, when an external consumption creates a counter period for an annual or calendar year sub limit counter, it does not create a corresponding counter period for the composite limit. Only the consumption is added to the composite limit counter.

Resolution:

Counter periods are now created for composite limits as well

36515179

3-36366863461

NXT-29189

Evaluate condition not working on dynamic records in create mode

Description:

The evaluate condition is not working on dynamic records during create mode, but it works in view and edit mode.

Resolution:

Evaluate condition can be configured on dynamic records as well and it works fine in create and view-edit mode

36654284

3-36452370811

NXT-29426

Advanced search lov’s for dynamic fields are not loading in referencesheetlines

Description:

Not able to search using the LOV’s in the reference sheet lines page. When clicking in the LOV field an error occurs on the api/generic/flexcodes/search.

Resolution:

Proper results are displayed in the LOV for flexcodes based on diagnosis, procedures and providers, displays

36393319

3-35684326321

NXT-28973

Data from technical table is not cleaned up if an extract activity fails which leads to data accumulation

Description:

Data from technical tables were only getting cleaned for activities in 'CO' status. Which was causing accumulation of huge data.

Resolution:

Along with status 'CO' all other statuses except 'IN', 'IP' and 'QD' are now included as part of cleaning process. This ensures a more cleaner technical table, hence overcoming the issue of data accumulation

36492014

3-36178158771

NXT-29146

PII data is not correctly populated when setting corresponding property

Description:

PII data is filled in as NULL when setting property "ohi.baseview.exclude.pii" to false, even though they are not null. This is only the case for entities where certain attributes are PII if the entity is of a certain subtype, e.g. for Relation of subtype 'PERS', the code column is seen as PII. When the "ohi.baseview.exclude.pii" property is set to false, this data should be seen.

Resolution:

PII data is now correctly populated when setting property "ohi.baseview.exclude.pii" to false.

36593627

NXT-29327

Remove the usage of utl_tcp DBMS package in extract functionality

Description:

Using utl_tcp DBMS package requires explicit grant in SaaS environments. This has operational challenges as the grants that are explicitly granted are periodically revoked by DBA as part of a scheduled process

Resolution:

Removed the usage of utl_tcp DBMS package in extract functionality and replaced it with a standard DB function

36568724

3-36557573371

NXT-29292

Context condition in fee schedulelines floorplan doesn’t work

Description:

When we add a condition to the feeschedulelines floorplan by referencing an attribute of the feeschedule object it always returns null in the value

Resolution:

When we add a condition to the feeschedulelines floorplan by referencing an attribute of the feeschedule object it is loading as expected. The format to give condition in floorplan should be (context.)

36619054

3-36759433791

NXT-29383

Conditional evaluation is not working on primitive type LOV fields

Description:

Conditional evaluation is not working on primitive-type LOV fields while referencing any of the properties of lov selected.

Resolution:

Conditional evaluation is working on primitive type LOV fields.To enable field1 to have the entire context of the selected LOV value, we add a new attribute to the entity (context of the parent resource). This new attribute will be named 'name_of_FieldObj'. For the example above, it will be 'field1Obj', which will contain the entire context of the selected LOV value. This allows us to conditionally evaluate various scenarios by accessing context.field1Obj.code, and other similar fields.

Issues that were backported in previous Release / Patch

No backports.