Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.24.1.0.6

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.24.1.0.6.

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-16484	Accounting Details Per Financial Transaction Set This enhancement allows accounting details, as generated in the financial message, to be persisted. It also enables the inclusion or exclusion of the subject (policy/claim) and reversal indicator as bulking criteria when creating accounting details. Note: For financial transactions created prior to this feature, the reversal indicator cannot be excluded as part of the bulking criteria. Documentation Links: Operations Guide - Generate Accounting Detail Message Operations Guide - Generate Financial Message

Summary

Patch

POL-16484

Accounting Details Per Financial Transaction Set

This enhancement allows accounting details, as generated in the financial message, to be persisted. It also enables the inclusion or exclusion of the subject (policy/claim) and reversal indicator as bulking criteria when creating accounting details.

Note: For financial transactions created prior to this feature, the reversal indicator cannot be excluded as part of the bulking criteria.

Documentation Links:
Operations Guide - Generate Accounting Detail Message
Operations Guide - Generate Financial Message

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
POL-16484	Removed	ohi.financialmessage.includeaccounting This system property (to indicate if account details should be part of financial message or not) has been removed.

Ref

Action

Description

POL-16484

Removed

ohi.financialmessage.includeaccounting

This system property (to indicate if account details should be part of financial message or not) has been removed.

Web Services

Ref	Action	Description
POL-16484	Modified	Cancel Policy and Produce Invoice IP New parameters added in the request: Create Accounting Detail to Persist Dynamic Logic Function Include Subject for Grouping Accounting? Include Reversal Indicator In Accounting Grouping?
POL-16484	Modified	financialtransactions API Object has been made auditable
POL-16484	Modified	financialtransactiondetails API Object has been made auditable
POL-16484	Modified	financialtransactionprocessdata API Attribute accountingDetailGeneratedDateTime has been removed
POL-16484	Modified	basefinancialobjects API Object has been made auditable
POL-16484	Modified	accountingdetails API Reference to financial transaction has been replaced by financialMessageId. Attribute stampId is added. Reversal indicator has been made optional
POL-16484	Modified	Run Calculation and Produce Invoice for a Policy New parameters added in the request: Create Accounting Detail to Persist Dynamic Logic Function Include Subject for Grouping Accounting? Include Reversal Indicator In Accounting Grouping?
POL-16484	Removed	financialtransactions/{id}/accountingdetails/undo IP Has been replaced by functionality in unsend financial message
POL-16484	Removed	Long running operation for creating accounting details for financial transaction Has been replaced by functionality in Generate financial message.

Ref

Action

Description

POL-16484

Modified

Cancel Policy and Produce Invoice IP

New parameters added in the request:

Create Accounting Detail to Persist Dynamic Logic Function
Include Subject for Grouping Accounting?
Include Reversal Indicator In Accounting Grouping?

POL-16484

Modified

financialtransactions API

Object has been made auditable

POL-16484

Modified

financialtransactiondetails API

Object has been made auditable

POL-16484

Modified

financialtransactionprocessdata API

Attribute accountingDetailGeneratedDateTime has been removed

POL-16484

Modified

basefinancialobjects API

Object has been made auditable

POL-16484

Modified

accountingdetails API

Reference to financial transaction has been replaced by financialMessageId. Attribute stampId is added. Reversal indicator has been made optional

POL-16484

Modified

Run Calculation and Produce Invoice for a Policy

New parameters added in the request:

Create Accounting Detail to Persist Dynamic Logic Function
Include Subject for Grouping Accounting?
Include Reversal Indicator In Accounting Grouping?

POL-16484

Removed

financialtransactions/{id}/accountingdetails/undo IP

Has been replaced by functionality in unsend financial message

POL-16484

Removed

Long running operation for creating accounting details for financial transaction

Has been replaced by functionality in Generate financial message.

Data Conversion

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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
37751467		NXT-31298	Claim Lines Search Page - Claim Line Summary section, pend reason details does not appear
Description:	For the claim lines, where claim line level pend reason is added, the summary section does not show up pend reason details
Resolution:	Pend reason details are displayed properly in Claim Line Summary section in ClaimLines page
37751312		NXT-31297	Resolve pend reasons integration point stamps 'resolved by' user as internal system user
Description:	When a pend reason on a claim or claim line is resolved from claim lines page, the system records it as being resolved by an internal system user instead of the actual user who took the action.
Resolution:	The system now correctly records the actual user who resolved the pend on a claim or claim line, instead of the internal system user.
37757276		NXT-31313	Users are able to edit the same claim at the same time
Description:	Two users are able to edit the same claim at the same time. System is not throwing an error message that claim is being edited by another user and cannot be saved
Resolution:	Error message is shown when same version of claim is locked and being edited by another user. This prevents overwriting of the updates made by another user.
37031287	3-37528423931	NXT-30279	Additional Field values when filled are not retained after save
Description:	Additional field values of a dynamic record for a claim cannot be nullified by passing in empty tags
Resolution:	Additional field values of a dynamic record for a claim can now be nullified by passing in empty tags in the PATCH payload
37761338	3-39441721251	NXT-31331	Query to fetch user role history list for a user should be case insensitive
Description:	Query to fetch user role history list was performing a case sensitive match for the user login name, so when a new role was added/deleted for the user with a different case in login name, the said query could not retrieve the complete list from the database.
Resolution:	The query is fixed to perform a case insensitive match on the user login name.
37397503		NXT-30836	Initialize the attributes for joining in the Authorization filter at startup and remove explicit calls
Description:	A GEN-PROC-ERR error intermittently occurs when accessing certain APIs. Once this error happens, all subsequent API calls to the same resource fail with the same error. The only workaround is to restart the specific node/JVM. To resolve such issues, modify the initialization of the attributes for joining in the Authorization filter so that it is invoked during startup, eliminating the need for explicit calls.
Resolution:	All the filters are initialized during the application start up or during the object creation so that no exception happens during the initialization process later.
37475365	3-38685467541	NXT-30917	Restrict directly setting startDate and endDate on a Claim
Description:	The standard start/end date on the claim header are display-only fields, i.e., their values are automatically derived from the start and end dates on the claim lines and user should not be able to update these.
Resolution:	Users can no longer manually set the Start Date and End Date on a Claim.
37750010		NXT-31288	Action buttons are missing in Inbound/outbound exchanges page
Description:	Action buttons are not visible in File Imports page, user will not be able to 'build' in config migration exchange pages
Resolution:	Build option is visible in Exchange page to build and deploy config migration in other environments
37838432		NXT-31420	Deselection of claim lines is not working
Description:	When claimlines tab is configured as results, 'Select all' checkbox is not de-selecting the claimlines selected
Resolution:	The Select All option in the claim lines results tab is now working for both select and de-select
37665679		NXT-31172	Activities are not purged when auto-purge job is enabled
Description:	Auto-purge job fails due to integrity constraint violation when child record is present in act_activity_dyn table
Resolution:	Changing the deletion order to delete child entries first before deleting act_activities entries resolved the issue.
37764969		NXT-31339	Mandatory fields validation not working in UI and doesn’t prevent user to click save
Description:	UI (client side) validation not working when a record is collapsed or new row is added without filling mandatory fields for previously added row when the page is in drill down view mode. Instead business error is shown for mandatory field
Resolution:	UI validation error is shown for mandatory fields when they are not filled in and subsequent new row is added in drill down view mode
37765155		NXT-31340	User defined message is not shown when regex validation happens
Description:	Users can configure a Floorplan property to add Message Code and that readable message should be displayed in UI when regex validation happens as error message
Resolution:	User defined message will be displayed when regex validation happens for String and Number field
37744755	3-40137684801	NXT-31265	Claim Unfinalize Reasons: Default value set on the field or through conditional setting is not working
Description:	Default value on flexcode field (ex:unfinalizeDate) on unfinalize reason like "default": "${context.systemDateJET}" should set unfinalizeDate with system date. This is not working.
Resolution:	systemDateJET can be used in Claim Unfinalize Reasons dialog to set default value
37812748		NXT-31385	Single value non-time valid dynamic records cannot be cleared/deleted
Description:	It is not possible to clear all the values in Single value non-time valid dynamic record
Resolution:	Clear All action is made available on Single value non-time valid dynamic records to clear all the values in record
37805248		NXT-31379	User information is not available as a parameter in deepLink (external URL)
Description:	An external link created with param to display logged in user information doesn’t gets replaced by user’s displayName
Resolution:	Logged in user information can be used as param in external Links in JET UI
37779677	3-40014494281	NXT-31350	Claimline status value is different in claimLine Tab of Claim details page and claimline details page
Description:	Consider a claim in 'Manual Adjudication' status with multiple claimlines in 'To Be Approved' / 'To Be Denied' status. Claimline status value is different in results tab of claim details page and on claimline details page
Resolution:	Claimline status value is displayed consistently in claimLine results tab of Claim details page and when claimline details page is opened

BugDB

Internal

Summary

37751467

NXT-31298

Claim Lines Search Page - Claim Line Summary section, pend reason details does not appear

Description:

For the claim lines, where claim line level pend reason is added, the summary section does not show up pend reason details

Resolution:

Pend reason details are displayed properly in Claim Line Summary section in ClaimLines page

37751312

NXT-31297

Resolve pend reasons integration point stamps 'resolved by' user as internal system user

Description:

When a pend reason on a claim or claim line is resolved from claim lines page, the system records it as being resolved by an internal system user instead of the actual user who took the action.

Resolution:

The system now correctly records the actual user who resolved the pend on a claim or claim line, instead of the internal system user.

37757276

NXT-31313

Users are able to edit the same claim at the same time

Description:

Two users are able to edit the same claim at the same time. System is not throwing an error message that claim is being edited by another user and cannot be saved

Resolution:

Error message is shown when same version of claim is locked and being edited by another user. This prevents overwriting of the updates made by another user.

37031287

3-37528423931

NXT-30279

Additional Field values when filled are not retained after save

Description:

Additional field values of a dynamic record for a claim cannot be nullified by passing in empty tags

Resolution:

Additional field values of a dynamic record for a claim can now be nullified by passing in empty tags in the PATCH payload

37761338

3-39441721251

NXT-31331

Query to fetch user role history list for a user should be case insensitive

Description:

Query to fetch user role history list was performing a case sensitive match for the user login name, so when a new role was added/deleted for the user with a different case in login name, the said query could not retrieve the complete list from the database.

Resolution:

The query is fixed to perform a case insensitive match on the user login name.

37397503

NXT-30836

Initialize the attributes for joining in the Authorization filter at startup and remove explicit calls

Description:

A GEN-PROC-ERR error intermittently occurs when accessing certain APIs. Once this error happens, all subsequent API calls to the same resource fail with the same error. The only workaround is to restart the specific node/JVM.

To resolve such issues, modify the initialization of the attributes for joining in the Authorization filter so that it is invoked during startup, eliminating the need for explicit calls.

Resolution:

All the filters are initialized during the application start up or during the object creation so that no exception happens during the initialization process later.

37475365

3-38685467541

NXT-30917

Restrict directly setting startDate and endDate on a Claim

Description:

The standard start/end date on the claim header are display-only fields, i.e., their values are automatically derived from the start and end dates on the claim lines and user should not be able to update these.

Resolution:

Users can no longer manually set the Start Date and End Date on a Claim.

37750010

NXT-31288

Action buttons are missing in Inbound/outbound exchanges page

Description:

Action buttons are not visible in File Imports page, user will not be able to 'build' in config migration exchange pages

Resolution:

Build option is visible in Exchange page to build and deploy config migration in other environments

37838432

NXT-31420

Deselection of claim lines is not working

Description:

When claimlines tab is configured as results, 'Select all' checkbox is not de-selecting the claimlines selected

Resolution:

The Select All option in the claim lines results tab is now working for both select and de-select

37665679

NXT-31172

Activities are not purged when auto-purge job is enabled

Description:

Auto-purge job fails due to integrity constraint violation when child record is present in act_activity_dyn table

Resolution:

Changing the deletion order to delete child entries first before deleting act_activities entries resolved the issue.

37764969

NXT-31339

Mandatory fields validation not working in UI and doesn’t prevent user to click save

Description:

UI (client side) validation not working when a record is collapsed or new row is added without filling mandatory fields for previously added row when the page is in drill down view mode. Instead business error is shown for mandatory field

Resolution:

UI validation error is shown for mandatory fields when they are not filled in and subsequent new row is added in drill down view mode

37765155

NXT-31340

User defined message is not shown when regex validation happens

Description:

Users can configure a Floorplan property to add Message Code and that readable message should be displayed in UI when regex validation happens as error message

Resolution:

User defined message will be displayed when regex validation happens for String and Number field

37744755

3-40137684801

NXT-31265

Claim Unfinalize Reasons: Default value set on the field or through conditional setting is not working

Description:

Default value on flexcode field (ex:unfinalizeDate) on unfinalize reason like "default": "${context.systemDateJET}" should set unfinalizeDate with system date. This is not working.

Resolution:

systemDateJET can be used in Claim Unfinalize Reasons dialog to set default value

37812748

NXT-31385

Single value non-time valid dynamic records cannot be cleared/deleted

Description:

It is not possible to clear all the values in Single value non-time valid dynamic record

Resolution:

Clear All action is made available on Single value non-time valid dynamic records to clear all the values in record

37805248

NXT-31379

User information is not available as a parameter in deepLink (external URL)

Description:

An external link created with param to display logged in user information doesn’t gets replaced by user’s displayName

Resolution:

Logged in user information can be used as param in external Links in JET UI

37779677

3-40014494281

NXT-31350

Claimline status value is different in claimLine Tab of Claim details page and claimline details page

Description:

Consider a claim in 'Manual Adjudication' status with multiple claimlines in 'To Be Approved' / 'To Be Denied' status. Claimline status value is different in results tab of claim details page and on claimline details page

Resolution:

Claimline status value is displayed consistently in claimLine results tab of Claim details page and when claimline details page is opened

Issues that were backported in previous Release / Patch

No backports.