Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.23.2.0.3

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.23.2.0.3.

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

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.

4.24.1.0.0

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.

4.24.1.0.0

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

36245997

3-29168078521

NXT-28639

Query API should throw user-friendly message instead of TokenMgrError

Description:

If the querystring is not properly formatted, then a parsing exception is thrown in the response with 500 status.

Resolution:

The error message in case of a parsing exception has been modified to convey proper information and looks like the following "title": "GEN-PROC-ERR: An error occurred in processing the request; for more information about the error search the logging for occurrences of Parsing Exception: Lexical error at line 1, column 79. Encountered: <EOF> after : "\\'%)"

37078595

NXT-30316

Inbound Benefits/Products(Http) : Console error on Download Response Files

Description:

When a user tries to download a response file on the Inbound Benefits/Products (Http) page, the download does not go through and results in a console error

Resolution:

The user must ensure the appropriate response file has been imported. The download now goes through and there is no console error.

36967427

NXT-30184

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.

36949919

NXT-30160

Member lookup not working in claims

Description:

When no label was assigned to a field (e.g., an insurable entity without a label), clicking the lookup icon resulted in a console error. This prevented the lookup dialog from being triggered due to the absence of the label for that entity.

Resolution:

When no label is added to the field, the lookup is still successfully triggered.

36915020

NXT-29959

Unable to close a deeplink drawer in search object pages

Description:

When a deeplink is configured in a search page, the corresponding drawer opens, but the user is unable to close the drawer using the close icon. The page also throws an error.

Resolution:

The user can configure a deeplink drawer in a search page. Opening and closing the drawer works as expected using the buttons provided.

36930567

3-37528423954

NXT-30092

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

36584497

3-36499732951

NXT-29314

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:

Non null reached action value will be searched as per priority if at all the highest priority being the null. If Non null value exist that will be used for limit action (as per priority).

36531393

3-36392583761

NXT-29212

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.

36760110

3-37140647951

NXT-29638

Retrieval access restrictions Brand/Payer

Description:

Retrieval access restrictions for Brand/Payer are not present in API, when the brand/payer is restricted, you can get the claim with the API

Resolution:

We have added brand and payer access restriction on retrieval of a claim and its related entities such as claimLine, claimMesssage, claimLineMessage, etc. Now these records will not be accessible through API without proper access roles granted to the user.

36823218

NXT-29758

Integer field values are shown with separator (12,345 instead of 12345)

Description:

Enter '12345' in integer fields like house number in Persons page, it is getting displayed as '12,345'

Resolution:

Integer field values are shown without separators now

36651705

3-36632413411

NXT-29414

Validation for claim line message isn’t working while trying to add multiple claim lines.

Description:

Validation for claim line message isn’t working while trying to add more claim lines. UI allows user to save a claim line without message attached.

Resolution:

Validation gets triggered for claim line message while trying to add claim line

36915944

3-36983961191

NXT-30064

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.

36908640

3-37579890441

NXT-30040

Manual benefits page does not show the coverage labels and amounts

Description:

Manual benefits page does not show the coverage label, amount and numberOfUnits fields while opening the ManualBenefits dialog for every claimline.

Resolution:

Values for coverage label, amount and numberOfUnits fields are shown in Manual Benefits dialog.

36900137

3-37458376621

NXT-30014

Selection dropdown is not showing certain fields even though added in the LOV

Description:

Selection dropdown is not showing certain fields even though added in the LOV floorplan for Primitive types

Resolution:

Selection dropdown displays all the fields added in the LOV floorplan for Primitive types.

36921892

3-37458376637

NXT-30077

Conditional filter on LOV for primitive types is not getting picked up

Description:

The conditional filter on LOV for Primitive Types is not getting picked up. Direct filters for LOV for Primitive Types works fine, but conditional filter is not working

Resolution:

The conditional filter on LOV for Primitive Types is implemented now

36962572

NXT-30162

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

36943895

3-37656947111

NXT-30120

Flexcode field does not save null value when updated

Description:

When Empty/Null value is selected from flexcode dropdown and page is saved , the PATCH payload should have null value set for the flexcode field

Resolution:

Flexcode field values can be cleared and set to null value in JET UI page

36306256

3-35610906906

NXT-28773

Activities are not getting marked with TE status when system runs into critical memory state

Description:

When extract activity threw "TooManyRequestsException" exception, the activity status did not change to TE. But the trace file got created. Such activities stay in 'IP' status forever until restart happens.

Resolution:

When activities fails due to memory issue, the status of the activities are now updated via the native query.

Backports:

4.23.1.0.9

36911451

3-37575252321

NXT-30054

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

36817151

3-37284209921

NXT-29753

Fields missing in claim line limit

Description:

The system floorplan for claim line limits is missing the following fields: coverWithholdCategory , reachedAction and aggregationLevel

Resolution:

New fields added for claim line Limits(Cover With hold Category , Reached Action and Aggregation Level )

36909524

3-37458989331

NXT-30041

Flex code fields are not displaying as columns in the search table of procedure lookup

Description:

When flex code fields are added to the procedure lov floorplan, it should be visible in search criteria as well as in the search results table of the procedure lov lookup window. It is not displayed as columns now.

Resolution:

Flex code fields appear in the search results table as well

36934033

3-37502780451

NXT-30099

In claims financials screen, payment details are not displayed

Description:

Users are not able to see/ edit the following in Claims JET UI: 1. Payment section 2. Edit due date under fields 3. Edit bulking group in the invoice section

Resolution:

Payment Information Sections displays data now, edit is possible for due date and bulking group in invoice section. Note : Refresh action is added in Overview page to see updated information

36195585

NXT-28514

Incorrect result shown in Boilerplates Table

Description:

The boilerplate table shows incorrect results after performing the 'ADD' and then 'CANCEL' actions simultaneously. This behavior is generic to other table-based pages.

Resolution:

Correct results are shown after performing the 'ADD' and then 'CANCEL' actions simultaneously in table-based pages

36841552

NXT-29896

Values under pricing and benefit sections are not displayed under Claim Line Summary drawer for both working copy and CTR version

Description:

Values under pricing and benefit sections are not displayed under Claim Line Summary drawer. Also, navigate to claim line detail page and check the summary, the values are not displayed when we select any CTR version , but displayed in case of working copy

Resolution:

Fix added to show Pricing and Benefits section under claimline summary that opens on clicking more link

36841276

NXT-29894

Messages do not return the variable details

Description:

Messages do not return the variable details in claim header summary and drawer, even though they are being returned by API.

Resolution:

Messages display the variable details in claim header summary and claim line summary drawer.

36870902

3-37314698941

NXT-29945

Unable to add claim subline on a claim line

Description:

For a claim, unable to add claim sub line under a claim line.

Resolution:

User can now add claim sub line from UI and API.

Issues that were backported in previous Release / Patch

BugDB Internal Summary Backport BugDB SR

36306256

NXT-28773

Activities are not getting marked with TE status when system runs into critical memory state

4.23.1.0.9

36306257

3-35610906906