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. Documentation Links: Developer Guide - Dynamic Logic - References - Validations
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. Documentation Links: Developer Guide - Financials - Create Accounting Details Developer Guide - Financials - Undo Accounting Details Operations Guide - Financial - Create Accounting Details from Registration

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.

Documentation Links:
Developer Guide - Dynamic Logic - References - Validations

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.

Documentation Links:
Developer Guide - Financials - Create Accounting Details
Developer Guide - Financials - Undo Accounting Details
Operations Guide - Financial - Create Accounting Details from Registration

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

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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

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

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Dynamic Logic

This section intentionally left blank.

UI Changes

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Breaking Changes

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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

BugDB

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.