Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.2.0.1

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.2.0.1.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.23.2.x is only compatible with other Oracle Health Insurance applications release version 4.23.2.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

NXT-28020

Attach additional diagnoses to a claim

This enhancement introduces new predefined methods to replace diagnosis codes in a claim or claim line as part of the automated process flow.

The methods help map one type of diagnosis coding system to another, for example, from ICD-9 to ICD-10.

Documentation Links:
Developer Guide - addDiagnosis and deleteDiagnosis

4.23.1.0.5

POL-12778

Extracts: Decouple bucket size from fetch size

When an extract is executed, the application creates a global activity. The global activity spawns multiple child activities. Each child activity fetches a specific number of entities and stores them in a data file. The ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS system property determines the number of entities fetched per child activity or the fetch size.

All the fetched entities per child activity, are stored in the same data file. Therefore, the higher the value of the system property, the higher the number of entities gathered in a single data file. This could cause memory issues when a large number of entities and subresources (from a single data file) are fetched into the memory at the same time.

This enhancement introduces properties to separate the fetch size from the data file size. Decoupling both values enables each child activity to fetch the entities in smaller chunks. Within a child activity, each chunk is processed sequentially but multiple child activities are processed in parallel. This reduces memory usage.

The ohi.extract.datafilesize property configures the number of entities to store in a single data file and has a default value of 500.
The ohi.processing.chunksize.SELECT_EXTRACT_ITEMS` property determines the size of a chunk and has a default value of 100. The value of this property represents the number of entities fetched at the same time in a single chunk. Setting a higher value for this property (for example, 500) decreases the duration of the extract as the number of entities fetched each time increases.
The ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS is no longer required and hence can be removed from the configuration.

The change of property values is only recommended if the application is facing issues performing at optimal levels.

Documentation Links:
Installation Guide - Application Properties

3.22.2.0.18, 4.23.1.0.4

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

Ref	Action	Description
NXT-28761	Added	ohi.oauth.token.jwt.assertion.param.name Name of JWT assertion parameter used in OAuth token request. It could be different across OAuth server. Default value is "assertion"
POL-12778	Added	ohi.processing.chunksize.SELECT_EXTRACT_ITEMS This property controls how many items the system exports in one chunk. Once a single chunk is extracted, the memory gets cleared and the system will continu with the next chunk. The default value for this property is 100. If the value of ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS is currently set to a lower value than 100, we recommend to use that value for this property as well.
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 entities are gathered in a single Data File. Therefore, this property has a similar function to the removed ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS property. The default value of this property is 500. We suggest a value between 1 and 1000, depending on the desired number of datafiles to be generated.
POL-12778	Added	ohi.processing.chunksize.SELECT_EXTRACT_ITEMS.{0} This property controls how many items the system exports in one chunk per entity. Once a single chunk is extracted, the memory gets cleared. The placeholder should be replaced with the entity name, to be similar as the resourceName attribute in the Extract definition.
POL-12778	Removed	ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS This property was formerly used to determine the number of entities fetched within a single child activity and therefore also determines the number of entities to be created in a data file. Now that those sizes as decoupled, this property does not serve any function anymore. Therefore, this property can be removed from the configuration (e.g. properties file)

Ref

Action

Description

NXT-28761

Added

ohi.oauth.token.jwt.assertion.param.name

Name of JWT assertion parameter used in OAuth token request. It could be different across OAuth server. Default value is "assertion"

POL-12778

Added

ohi.processing.chunksize.SELECT_EXTRACT_ITEMS

This property controls how many items the system exports in one chunk. Once a single chunk is extracted, the memory gets cleared and the system will continu with the next chunk. The default value for this property is 100. If the value of ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS is currently set to a lower value than 100, we recommend to use that value for this property as well.

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 entities are gathered in a single Data File. Therefore, this property has a similar function to the removed ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS property. The default value of this property is 500. We suggest a value between 1 and 1000, depending on the desired number of datafiles to be generated.

POL-12778

Added

ohi.processing.chunksize.SELECT_EXTRACT_ITEMS.{0}

This property controls how many items the system exports in one chunk per entity. Once a single chunk is extracted, the memory gets cleared. The placeholder should be replaced with the entity name, to be similar as the resourceName attribute in the Extract definition.

POL-12778

Removed

ohi.processing.bucketsize.SELECT_EXTRACT_ITEMS

This property was formerly used to determine the number of entities fetched within a single child activity and therefore also determines the number of entities to be created in a data file. Now that those sizes as decoupled, this property does not serve any function anymore. Therefore, this property can be removed from the configuration (e.g. properties file)

Web Services

Ref	Action	Description
NXT-28761	Added	Generic API for OAuthParameter Introduced generic APIs to manage OAuth parameters. Refer /generic/oauthparameters/metadata to know available endpoints to manage OAuthParameter entity
NXT-28761	Modified	generic/oauthassertionjwtbearergrantconfigurations/ Supports configuration of OAuth parameters through oAuthClientParameters
NXT-28761	Modified	generic/oauthclientcredentialsgrantconfigurations Supports configuration of OAuth parameters through oAuthClientParameters

Ref

Action

Description

NXT-28761

Added

Generic API for OAuthParameter

Introduced generic APIs to manage OAuth parameters. Refer /generic/oauthparameters/metadata to know available endpoints to manage OAuthParameter entity

NXT-28761

Modified

generic/oauthassertionjwtbearergrantconfigurations/

Supports configuration of OAuth parameters through oAuthClientParameters

NXT-28761

Modified

generic/oauthclientcredentialsgrantconfigurations

Supports configuration of OAuth parameters through oAuthClientParameters

Data Conversion

This section intentionally left blank.

Dynamic Logic

Ref	Action	Description
NXT-28020	Added	addDiagnosis This method is adds a diagnoses code to a claim or claimline through dynamic logic within a derivation rule.
NXT-28020	Added	deleteDiagnosis This method removes a diagnoses code from a claim or claimline through dynamic logic within a derivation rule.

Ref

Action

Description

NXT-28020

Added

addDiagnosis

This method is adds a diagnoses code to a claim or claimline through dynamic logic within a derivation rule.

NXT-28020

Added

deleteDiagnosis

This method removes a diagnoses code from a claim or claimline through dynamic logic within a derivation rule.

UI Changes

This section intentionally left blank.

Breaking Changes

This section intentionally left blank.

Bug Fixes

BugDB	SR	Internal	Summary
36251082	3-28606893871,3-35610906861	NXT-28661	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.
36304156	3-34612052061	NXT-28761	OAuth parameters should be configurable
Description:	OHI product supports only standard OAuth parameters. As its value/name can deviate across OAuth server, OHI application isn’t able to establish connection with OAuth server.
Resolution:	Introduced capability in OHI product to define custom OAuth parameters. These parameters can be reused across different OAuth clients later.
36262726		NXT-28670	Resolve Pend reason is not working from Claim Line level when the claim line is configured as Tab in Claims floorplan
Description:	When a claimline is configured as tab in claims floorplan, and user tries to resolve pend from claim line level, it does not work and throws console error.
Resolution:	Resolve Pend reason works fine at Claim Line level when the claim line is configured as tab in Claims floorplan
36203938	3-34786906091	NXT-28540	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.
36261004	3-35639469161	NXT-28667	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
36300644	3-34786906091	NXT-28749	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.
36285031	3-35695968321	NXT-28718	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
36427788	3-35684326321	NXT-29040	Gathering statistics on technical table for every extract activity is inefficient
Description:	Gathering statistics on technical table for every extract activity is inefficient as it was enabled by default for all cases and because of parallel extracts performance was degraded.
Resolution:	A check is added which will ensure statistics are gathered only in certain cases. Hence, improving the efficiency of extract activity.
36406065	3-35993367661	NXT-28984	Currency issue in jet page when creating a parameter for a product benefit specification
Description:	Currency is sent as "USD" in request payload irrespective of currency sent in "type" column in UI , while creating a limit parameter for a Product Benefit Specification. Hence when any user who doesn’t have USD currency, error is showing as "Currency code USD is unknown"
Resolution:	Currency is sent as it is seen in "type" column in UI , while creating a limit parameter for a Product Benefit Specification and no error is seen while saving
36150559		NXT-28392	Individual providers - Unable to edit service address configured as deeplink in rendering address tab
Description:	It is not possible to edit resources which are configured as Deeplinks. For example in Individual providers, it is not possible to edit service address in rendering address tab. On click of edit button in service address drawer, its directly navigating back to individual providers page and not possible to edit/save
Resolution:	Edit works fine in Deeplink drawers now and also the values are saved properly on the resource configured as deeplink
36272194		NXT-28693	Generate baseviews fails intermittently with CacheCreationException
Description:	Generate baseviews fails intermittently with CacheCreationException: Name of the cache entityNamePropertyCache already exists.
Resolution:	Generation of base views works fine without any intermittent exceptions.
36377374		NXT-28946	Save and cancel shortcuts aren’t working for create HRR pages
Description:	The save and cancel shortcuts did not work for the create HRR pages.
Resolution:	The save and cancel shortcuts now work for the create HRR pages.
36463125		NXT-29100	Flexcodes API returns value of ID as number instead of String
Description:	Flexcodes API returns the value of id as a number instead of String but the definition defined the type of ID as string
Resolution:	The Flexcodes API now returns value of Id, created by and last updated by as Strings as defined in the definition
36382380		NXT-28953	Additional Fields at tab level is not retrieving the data.
Description:	The data of extensible fields under the more action drawer in a tab table is not showing up even after save.
Resolution:	The data of extensible fields under the more action drawer in a tab table is displayed properly after the save operation is performed.
36433071	3-36176430291	NXT-29050	Dynamic records ID should be returned as string in the API response
Description:	The ID of dynamic records of resources are returned as number (Long) in the API response, they should be returned as String.
Resolution:	The Dynamic records ID was transformed from Long to String in the API response
36445738	3-36004628854	NXT-29067	Edit field is present in referencesheet headers even after making the fields non editable in the floorplan
Description:	Edit field is present in REFERENCESHEET headers even after making the fields non editable in the floorplan. Enable the custom floorplan for REFERENCESHEET page and remove edit action from action component. The edit option is still there.
Resolution:	Edit button will not appear if edit action is removed from the floorplan in Reference sheets page
36307912		NXT-28774	JWT bearer grant type is not working
Description:	OHI supports both client_credentials and urn:ietf:params:oauth:grant-type:jwt-bearer (shortly referred as JWT bearer) grant types in OAuth, however JWT bearer grant type is not working as expected.
Resolution:	Fixed logical issues in code to make it working
35826004	3-33232690791	NXT-27738	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

36251082

3-28606893871,3-35610906861

NXT-28661

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.

36304156

3-34612052061

NXT-28761

OAuth parameters should be configurable

Description:

OHI product supports only standard OAuth parameters. As its value/name can deviate across OAuth server, OHI application isn’t able to establish connection with OAuth server.

Resolution:

Introduced capability in OHI product to define custom OAuth parameters. These parameters can be reused across different OAuth clients later.

36262726

NXT-28670

Resolve Pend reason is not working from Claim Line level when the claim line is configured as Tab in Claims floorplan

Description:

When a claimline is configured as tab in claims floorplan, and user tries to resolve pend from claim line level, it does not work and throws console error.

Resolution:

Resolve Pend reason works fine at Claim Line level when the claim line is configured as tab in Claims floorplan

36203938

3-34786906091

NXT-28540

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.

36261004

3-35639469161

NXT-28667

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

36300644

3-34786906091

NXT-28749

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.

36285031

3-35695968321

NXT-28718

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

36427788

3-35684326321

NXT-29040

Gathering statistics on technical table for every extract activity is inefficient

Description:

Gathering statistics on technical table for every extract activity is inefficient as it was enabled by default for all cases and because of parallel extracts performance was degraded.

Resolution:

A check is added which will ensure statistics are gathered only in certain cases. Hence, improving the efficiency of extract activity.

36406065

3-35993367661

NXT-28984

Currency issue in jet page when creating a parameter for a product benefit specification

Description:

Currency is sent as "USD" in request payload irrespective of currency sent in "type" column in UI , while creating a limit parameter for a Product Benefit Specification. Hence when any user who doesn’t have USD currency, error is showing as "Currency code USD is unknown"

Resolution:

Currency is sent as it is seen in "type" column in UI , while creating a limit parameter for a Product Benefit Specification and no error is seen while saving

36150559

NXT-28392

Individual providers - Unable to edit service address configured as deeplink in rendering address tab

Description:

It is not possible to edit resources which are configured as Deeplinks. For example in Individual providers, it is not possible to edit service address in rendering address tab. On click of edit button in service address drawer, its directly navigating back to individual providers page and not possible to edit/save

Resolution:

Edit works fine in Deeplink drawers now and also the values are saved properly on the resource configured as deeplink

36272194

NXT-28693

Generate baseviews fails intermittently with CacheCreationException

Description:

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

Resolution:

Generation of base views works fine without any intermittent exceptions.

36377374

NXT-28946

Save and cancel shortcuts aren’t working for create HRR pages

Description:

The save and cancel shortcuts did not work for the create HRR pages.

Resolution:

The save and cancel shortcuts now work for the create HRR pages.

36463125

NXT-29100

Flexcodes API returns value of ID as number instead of String

Description:

Flexcodes API returns the value of id as a number instead of String but the definition defined the type of ID as string

Resolution:

The Flexcodes API now returns value of Id, created by and last updated by as Strings as defined in the definition

36382380

NXT-28953

Additional Fields at tab level is not retrieving the data.

Description:

The data of extensible fields under the more action drawer in a tab table is not showing up even after save.

Resolution:

The data of extensible fields under the more action drawer in a tab table is displayed properly after the save operation is performed.

36433071

3-36176430291

NXT-29050

Dynamic records ID should be returned as string in the API response

Description:

The ID of dynamic records of resources are returned as number (Long) in the API response, they should be returned as String.

Resolution:

The Dynamic records ID was transformed from Long to String in the API response

36445738

3-36004628854

NXT-29067

Edit field is present in referencesheet headers even after making the fields non editable in the floorplan

Description:

Edit field is present in REFERENCESHEET headers even after making the fields non editable in the floorplan. Enable the custom floorplan for REFERENCESHEET page and remove edit action from action component. The edit option is still there.

Resolution:

Edit button will not appear if edit action is removed from the floorplan in Reference sheets page

36307912

NXT-28774

JWT bearer grant type is not working

Description:

OHI supports both client_credentials and urn:ietf:params:oauth:grant-type:jwt-bearer (shortly referred as JWT bearer) grant types in OAuth, however JWT bearer grant type is not working as expected.

Resolution:

Fixed logical issues in code to make it working

35826004

3-33232690791

NXT-27738

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.