Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.24.1.0.4

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.24.1.0.4.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.24.1.x is only compatible with other Oracle Health Insurance applications release version 4.24.1.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

POL-15307

Financial: Ability to Send Accounting Details Separately

OHI application sends out accounting details along with the financial message. So, the granularity of the grouping of account details is bounded by invoice grouping. That is, only the details within an invoice can be grouped. This poses challenges for customers who require accounting to be done at a different level compared to the invoice. For example, an invoice is per member, but accounting is across members for a product.

With this enhancement, it will be possible to send out accounting details as part of a separate batch

Documentation Links:
Administration Guide - Nullable Foreign Keys
Developer Guide - Create Accounting Details for a Registration
Developer Guide - Predefined Methods - Add Registration and Update Registration
Operations Guide - Dynamic Logic - Function - Create Accounting Detail (Financial Transaction)
Operations Guide - Generate Accounting Detail Message
Operations Guide - Create Accounting Details from Registrations

POL-16031

Start integration gateway exchange using a list of payment registrations as its payload

This enhancement introduces the ability to invoke an insurance gateway exchange, using a list of payment registrations as its payload. The exchange is invoked either by API or through a new set of controls in the user interface.

Documentation Links:
Developer Guide - Macro Integration Point
Operations Guide - Macro Introduction

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

POL-15307

Added

ohi.processing.datafilesize.GENERATE_ACCOUNTING_DETAIL_MESSAGES

Utilized to to create one or multiple data files for generated accounting detail message.

Default value = 1, allowed value: postive numeric value.

POL-15307

Added

ohi.financialmessage.includeaccounting

Should accounting details be included when financial message is generated? (default value true)

POL-15307

Added

ohi.financialmessage.create.noninvoiceaccdetail

Decides the creation of non-invoice accounting details in financial message. If set to true, activity creates non-invoice account details in financial message. If the property is set to 'false', non-invoice accounting details won’t be created

Web Services

Ref Action Description

POL-15307

Added

accountingdetails API

Read-only API to query on accounting details (new entity).

POL-15307

Added

financialtransactions/{id}/accountingdetails/undo IP

New IP to make accounting details for a specific transaction void

POL-15307

Modified

financialtransactionprocessdata API

Added attribute accountingDetailsGeneratedDateTime

POL-16031

Modified

Macro IP

Attribute requestContextList is added

POL-16031

Modified

Generic API for Macro definition

Value REGI ("Registration" ) and list indicator are added.

POL-16031

Modified

Generic API for Macro history

Subject ID is made optional

Data Conversion

Ref Action Description

POL-16031

Added

List indicator

New indicator list on Macro definition is set to false

Dynamic Logic

This section intentionally left blank.

UI Changes

Ref Action Description

POL-15307

Added

FI0027 Accounting Details

Added Accounting Details page as object navigation link in claims page (Claims application) and policies page (Policies application)

POL-15307

Modified

FI0027 Accounting Details

Custom UI properties i.e. 'segmentsJET' and 'accountingAttributesJET' are introduced for the accounting details in claims page (Claims application) and policies page (Policies application)

POL-15307

Modified

FI0014 Registrations

Create, Update, Delete support is added in Registrations page (Policies application)

POL-16031

Added

Macro Definitions

New page added to create, update, delete Macro Definitions in Claims Application

POL-16031

Modified

Payment Registrations

Registrations page renamed to Payments registrations to support create, update, delete Registration and also to start a macro and view macro history

Breaking Changes

This section intentionally left blank.

Bug Fixes

BugDB SR Internal Summary

37371167

3-38862064491

NXT-30810

Conditional readonly- false is opening the field as editable even in view mode

Description:

Make a field readonly:true/false based on a condition. It is noticed that when "readonly": false is set for a field, the field remains editable even in view mode.

Resolution:

Field is not editable in view mode when it is set as readonly through condition

37356754

3-38861515651

NXT-30793

Conditional readonly setting is clearing the defaulted values

Description:

Dynamic record changes to make a field readonly/editable based on a condition. The default value added to that field "Status" is clearing off after "Save".

Resolution:

Conditional readonly setting is not clearing the default values

37447203

NXT-30901

Value in flexcode field vanishes after saving on defaulting and with readonly as true

Description:

On any detail floorplan, if we default a flex Code and also used readOnly as true, but after saving the page record, the value of the flexCode is disappearing. So, the combination of readOnly and default properties is not working on flex code fields.

Resolution:

Value in flexcode field retains as is after saving on defaulting and with readonly as true

37151575

NXT-30473

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

Description:

When pend reasons are resolved by the pendresolution criteria IP, internal system user is used for resolving the claim or claim line pends. Instead of this the current user should be used to resolve the pends via pend resolution criteria IP.

Resolution:

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

37095725

3-38012093931

NXT-30403

LOV on procedures gives "no records found " in Reference sheets page

Description:

In JET UI, Reference Sheets page, when a record definition has the flex code set then lov shows "no record found"

Resolution:

LOV on Procedures configured as flexcode set displays proper values in Reference Sheets page

37391824

NXT-30831

Flex Code Group Details Page - End date is missing in the table

Description:

Navigate to object navigation: "Flex Code Group Details" of Flex Code group page. In the table, only 2 fields - Start Date and Flex Code is displayed, end date is missing

Resolution:

End date field is added to Flex Code Group Details Page

37406960

3-38991321131

NXT-30841

Clicking on the “eye” of a products benefits specifications, no results appear

Description:

When clicking on the "eye" icon for a product’s benefit specifications, no results are displayed.

Resolution:

It is now possible to open and view product benefit specifications details page.

37446723

NXT-30898

Boilerplate texts are not being shown while configuring labels for multivalue fields

Description:

When user configures label for multivalue field which has displayLabel, it is showing boilerplate text “code” instead of the actual boilerplate text value

Resolution:

Boilerplate text values are shown while configuring labels for multivalue fields

36997405

NXT-30232

Claims Line Tab: More drawer details are not displayed completely

Description:

Click on More link in claimlines tab so that drawer opens with the details. It is seen that some of the sections are not displayed completely

Resolution:

Alignment issues are fixed in claimlines section More drawer and information is displayed completely

37387101

NXT-30828

Consumptions doesn’t load data at view authorization page

Description:

Consumptions does not load data at view authorization page

Resolution:

Consumptions table data is loading now in authorization page.

37012707

NXT-30256

Inbound Benefits/Products (HTTP): No "messages" loading in import history

Description:

Navigate to Inbound Benefits/Products (HTTP). Import a file and then go to import history or directly navigate to import history. Messages are not loading for both failed and success record

Resolution:

Messages are displayed for both failed and success record

37385469

3-38959466811

NXT-30824

Dynamic DATE field is getting data type validation error when defaulted to SystemDateJET

Description:

The system is throwing the below data type validation error when user defaults the field to SystemDateJET. GEN-HTTP-005: Value "2024-12-08T23:32:59.231-05:00" is not of type "Date"

Resolution:

User can set default value to date field as SystemDateJET

Issues that were backported in previous Release / Patch

No backports.