Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.24.1.0.5

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.24.1.0.5.

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-15884

User Defined Validations for Registrations

This enhancement introduces the ability to define additional validations for the registrations entity when using generic APIs to create or update registrations. A new dynamic logic of signature User Defined Validation (Registration) is introduced to support this functionality.

POL-16447

Repeatable Generation of Accounting Details

This enhancement introduces embedded logic that ensures that the same accounting details for a given grouping value and registration combination are not generated twice.

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

This section intentionally left blank.

Web Services

Ref Action Description

POL-16447

Added

accountinggroupingdetails API

New read-only API

POL-16447

Modified

registrations/{id}/accountingdetails/undo IP

Added removal of accounting detail groupings

POL-16447

Modified

registrations API

Added accountingDetailGroupingList (display only)

POL-16447

Modified

registrations/{id}/accountingdetails/create IP

Added check if accounting detail grouping already exists: FIN-IP-REGI-007

Data Conversion

This section intentionally left blank.

Dynamic Logic

This section intentionally left blank.

UI Changes

This section intentionally left blank.

Breaking Changes

This section intentionally left blank.

Bug Fixes

BugDB SR Internal Summary

37657244

3-35321985291

NXT-31164

All the 'fee schedule line import activity messages' are not visible on 'global activities' page

Description:

All the 'Fee Schedule Line Import activity messages' are not visible on 'Global Activities' page. The messages for the child activities are not displayed.

Resolution:

If activity has compositemessages, multiple Message Tabs are displayed in UI.

37436848

3-38835357681

NXT-30877

Manual benefits pop-up shows all the details including superseded values

Description:

Manual Benefits pop-up is supposed to show only the non-superseded details. View the claim and open manual benefits pop-up. It shows all the claim line rule coverage list.

Resolution:

Manual Benefits pop-up displays only the non-superseded details

37413415

3-39029653111

NXT-30846

Referencesheet lines table on select / deselect columns, previous data is not visible in table

Description:

In the JET UI, on the referencesheet lines table pages, when column check is selected or deselected table reloads and complete data is not visible

Resolution:

Table reload doesn’t happen when columns are selected/deselected from columns dropdown in Referencesheet lines page

37610167

3-38056877861

NXT-31140

Default color is not working when flex code values are not mentioned in labels section for multivalue fields

Description:

Create a flexcode definition, configure it to claims page as a multivalue from usages page. Add this to floorplan as a label with displayLabel attribute. If the flexcode has 5 values, while configuring label values mention only 3. Now while configuring multivalue , select the field that is not mentioned in labels. None of the labels are coming on the claim

Resolution:

Default color is applied when flex code values are not mentioned in labels section for multivalue fields

36988242

NXT-30210

Error on updating a dynamic field usage from single value non time-valid to multi value non time-valid

Description:

NPE error is thrown on updating a dynamic field usages from single value non time-valid to multi value non time-valid

Resolution:

Modified logic so that conversion of single-valued non time-valid field to multi-valued does not throw any NPE exception.

36993989

3-35321985291

NXT-30223

All Fee Shedule Line Import Activity messages are not visible on Global Activities page

Description:

All the 'Fee Schedule Line Import activity messages' are not visible on 'Global Activities' page. The messages for the child activities are not displayed.

Resolution:

37188392

3-36396091781

NXT-30548

Claim fails with pricing mismatch when covered amount on claim and its lines are in different currencies

Description:

If a claim meets a benefit error during claims processing, system tries to clear previous results on claim lines. If given claim is not paid, total covered amount of claim is adjusted by considering claim lines. If claim’s currency is different from covered amount currencies on claim lines, claim’s total covered amount adjustment goes wrong.

Resolution:

During claim line cleanup, claim line which is having covered amount currency different as compared to claim’s covered amount currency is not considered for claim’s total covered amount adjustment.

37436516

3-38082342431

NXT-30870

Improve the Activity recovery query when node crashes

Description:

When a node is crashed, the other nodes try to recover the activities from the crashed node. During this recovery the select query on activities was too costly resulting in SQLException "Socket read interrupted" - i.e connection timeout.

Resolution:

The SELECT query was optimized, and the index on the activity table was updated to prevent a full table scan. This significantly reduced the recovery cost and effectively resolved the connection timeout issue.

37552774

3-39589897271

NXT-31052

Processing of activities stuck with NPE on AggregateResumableActivityTask during node initialization

Description:

The Coherence service started processing activities too early, before the node was fully initialized, causing the ServiceLocator to initialize prematurely and resulting in a NullPointerException (NPE), which destabilized the entire application.

Resolution:

Delayed Coherence session creation until system initialization is complete, ensuring a stable environment for subsequent operations.

37196914

3-37991339551

NXT-30558

Message RCL-CADE-002 shouldn’t be obsolete

Description:

Message RCL-CADE-002 is used in case definition validation. Currently it has been marked as obsolete. Obsolete messages aren’t shifted with product. Hence case definition validation can’t find this message.

Resolution:

Marked message as not obsolete.

37075387

3-37991339551

NXT-30357

Case definition PATCH fails with message RCL-CADE-002

Description:

While patching (with dynamic data) a case definition which has primary dynamic logic already set fails with message RCL-CADE-002.

Resolution:

Instead of considering dynamic logic ID in validation, considered dynamic logic entity reference itself.

37434653

3-38974835961

NXT-30868

Overturned value, overturn action and severity label is not displayed

Description:

Overturned value is not displayed in the claim messages tab. Overturn action is not available for a claim in Manual Adjudication Status. Severity of the messages with value "Deny" does not have a label associated to it in the claim messages tab.

Resolution:

Overturned value, overturn action and severity label is be displayed for a claim in Manual Adjudication Status

37552077

NXT-31049

Error on create macro definition page

Description:

Create Macro definition page is not loading for second page. User has to do hard reload to create the record

Resolution:

"Create Macro Definition" page opens without issue for second time.

37644169

3-39375247731

NXT-31155

Claim Lines page fails to load from Claims window when a condition is configured for Claim Lines floorplan.

Description:

When a floorplan condition is set on the Claim Lines floorplan for a referenced resource (e.g., context.claim.claimForm.code == 'FORM2'), along with the necessary tags for claim and claim line, the Claim Lines page fails to load even if the claim form matches.

Resolution:

Claim Line page loads when a condition is configured on the floorplan based on claim context

37677689

NXT-31196

ClaimLine summary shows blank in Results configuration

Description:

When claimline tab is configured as results in Claims page, clicking on claimline summary shows blank

Resolution:

Claimline summary displays the claimline details as expected

37702382

NXT-31215

When dynamic record with Currency as a field is configured, the page won’t load

Description:

In record definition page, among the fields list add a field with name as "currency" and fill in the other details. Create a usage for any page like claims with this record definition. Open the respective page and we see the page won’t be loaded

Resolution:

Claims page (any page having dynamic record with currency as a field) opens without any error

Issues that were backported in previous Release / Patch

No backports.