Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.1

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.1.

Version compatibility: Oracle Health Insurance Claims Adjudication Release 4.25.1.x is only compatible with other Oracle Health Insurance applications release version 4.25.1.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

NXT-31600

Access restriction on ability to overturn deny messages

This enhancement extends the message group access restriction check to include the deny message overturn indicator update on claims and claim lines

4.24.1.0.8

NXT-31617

Increase the length of scope attribute on OAuthClientCredentialsGrantConfiguration entity

The scope attribute in the OAuthClientCredentialsGrantConfiguration entity is currently limited to 100 characters which is insufficient to store scope values.

4.24.1.0.7

NXT-31704

Deeplink to Claims from Adjudication Consumptions

With this enhancement deeplink is added to view claims from consumptions

POL-15334

Additional Data Masking Functions

This enhancement introduces two new data masking functions:

  • Text hash with seed, preserve size

  • Number hash with seed, preserve size

Along with the new masking functions:

  • New fields are added to the list of allowed native fields that can be part of the masking process.

  • Additional tables/columns are now purged as part of the masking process.

4.24.1.0.8

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

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Web Services

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Data Conversion

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Dynamic Logic

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UI Changes

Ref Action Description

NXT-31704

Modified

Adjudication Limit Counters

Deep link added to the Claim Code/Description column in the Limit Consumptions section

Breaking Changes

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Bug Fixes

BugDB SR Internal Summary

37886016

3-40242015751

NXT-31484

Generate financial message fails when length of invoice bulking group on transactions exceeds 100

Description:

Generate financial message fails when length of invoice bulking group on transactions exceeds 100

Resolution:

Generate Financial message activity will complete successfully for transactions with invoice bulking group of length greater than 100 .

37921056

NXT-31562

Attributes, Segments, More sections retain previous search results in Accounting details page

Description:

In the claims accounting details page, when a search is performed without closing the previous search results, the Attributes, Segments and More sections are not refreshed. These fields retain the previous search results.

Resolution:

All fields are now refreshed after a search in Accounting details page.

37887131

NXT-31490

Generateaccountingmessage integration point populates reversal as false for null reversal accounting details

Description:

Reversal indicator is optional for accounting details. But the generate accounting message operation does not reflect that the reversal indicator could be empty.

Resolution:

Accounting details are now grouped by generateaccountingmessage integration point based on reversal being true or false or null. When the reversal indicator is null, the response item does not display the reversal field.

37842934

NXT-31423

ClaimLine messages with 'Suppress logging in UI' enabled is displayed in expanded mode

Description:

A claimline message with 'Suppress logging in UI' flag enabled is still displayed in the user interface when claimline is configured as results layout and expanded view mode is enabled in Claims page

Resolution:

ClaimLine message with 'Suppress logging in UI' enabled are no longer displayed in expanded view mode

37917886

3-40601455857

NXT-31556

Filter with context string is not working in claim line table edit mode

Description:

When a user attempts to filter claim line "procedure2" based on the user selection of "procedure" field, the filter is only applied during trigger condition of value change. It is not applied during the claim line edit operation through filter.

Resolution:

The context is now evaluated to correct value during the claim line edit operation when used with filter condition.

37914608

NXT-31554

In claims page the section separator shows up only for the last section

Description:

In Claims page, section separator is not shown when there is more than one section. The separator is missing between the sections 1, 2 and 3

Resolution:

Section separator is now displayed for all the sections in form component

37892375

NXT-31500

Apply and next button does not allow navigating to the next claim line

Description:

While editing a claim line, 'Apply and Next' button on the claim line details page does not allow navigating to the next claim line.

Resolution:

Clicking the Apply and next button saves the current claim line and navigates to the next one as expected.

37908500

NXT-31537

Form table: Sort is not working when records are loaded after changing the sort order

Description:

On changing the sort order from ascending to descending or vice versa in form table, sort is not working

Resolution:

Sorting works fine in Form table now

37893788

NXT-31509

Claims API does not update existing external claims data.

Description:

PUT and PATCH operations on claims API gives success response, but does not update external claims data.

Resolution:

User can now edit external claim data using PUT or PATCH operation on claims API

37912322

NXT-31541

Mandatory multivalued dynamic fields create extra row that prevents saving data.

Description:

If a floorplan has mandatory multi-valued dynamic fields, populating these fields create new empty rows. This leads to error on saving.

Resolution:

The validation for the newly created rows in multi value fields will only be performed if data is present.

37914419

3-39900404711

NXT-31552

Conditional default value is not getting set based on trigger condition

Description:

The conditional default value logic is not functioning as expected. When a specific value is selected in one flex code field, it is supposed to trigger and set a default value in another flex code field. However, this default value is not being set based on the condition. Instead, any previously set default value is being cleared.

Resolution:

Fix added to ensure the default value is set based on the trigger condition.

37914460

NXT-31553

Claim Line Detail Page - Blank screen is displayed when summary section is opened after clicking on next or previous button

Description:

The summary section goes blank whenever it is opened on the claim line detail page after clicking on Next or Previous button while navigating from one claim line to another.

Resolution:

Claim line summary section can be viewed properly after clicking on the Next or Previous button

37913442

3-38056877861

NXT-31547

Labels are not displayed when configured in search page

Description:

When flexcodes are configured as labels in search page, it is not displayed. The labels are displayed properly in hierarchical recursive page

Resolution:

Labels for flex code fields are working as expected when configured in search page

37913469

3-40346571471

NXT-31548

Not able to retrieve parent context values in view mode of the page in a tab

Description:

Filtering out a field in the tab, based on the type of the claim does not work when the page is opened in view mode. But this works fine in create mode.

Resolution:

Conditional evaluation issue is fixed for tab detail pages in view, create and edit modes.

37921070

NXT-31564

Default value for a single value non-time valid dynamic record is displayed for existing records even in edit mode

Description:

The default value for a single value non-time valid dynamic record is currently displayed for existing records even in edit mode. This default value is expected to be displayed in create mode, but not in edit mode for existing records.

Resolution:

Default value is now not displayed when switching from view to edit mode for existing records.

37870603

3-40388321491

NXT-31459

No resolve link for pend reasons under Claims summary section if there are more than two pend reasons

Description:

The resolve link is displayed only for the first two pend reasons. If there are more pend reasons, they are displayed in 'See more' section but these do not have resolve link on them.

Resolution:

All the pend reasons are displayed in Claims summary section with an option to 'Resolve' pend. Additionally, Claim Line Summary section is modified as:
1) Summary Title gets ClaimLine Sequence Number
2) All messages and pends are now displayed in the drawer.
3) Resolved pends are displayed and marked as "Resolved" with the corresponding links disabled.
4) New section titles - Pend Reasons and Messages have been added to the drawer .

37843624

3-40369237351

NXT-31433

Claimline not highlighted for a finalized claim when 'details Inline' toggle is off

Description:

On clicking a claimline or on 'More' link for the claim line on a finalized claim , the claimline is not highlighted if 'details Inline' toggle is off.

Resolution:

Claimline is highlighted when the claim status is "finalized" and 'details Inline' toggle is off

37912922

NXT-31545

Allowed amount set to default currency when pricing is skipped or done manually on reprocessing a claimline with a different claimed amount currency

Description:

When claimed amount is not in default currency, reprocessing makes allowed amount currency as default currency if no provider pricing clauses are found. Even when it is priced manually, the claim line allowed amount is showing default currency and cannot be changed.

Resolution:

The claim line allowed amount picks up the currency from charged amount i.e, claimed amount if it exists.

37950440

NXT-31635

User information is not available to use in floorplans using userJET property

Description:

The userJET property in the floorplan does not support setting default values or filtering data based on the current user.

Resolution:

Id and displayName fields of userJET property can be used in the floorplan for setting default values or filtering data based on the current user.

38025513

NXT-31748

Multiple restart links appear in the claims page when a large claim with unresolved subclaim pend reasons is submitted more than once.

Description:

If a large claim submit fails due to unresolved pend reasons on the subclaims, clicking restart link without resolving the pend reasons leads to creation of new activities that fail again and in turn display new restart links. The system encounters array index out of range error when processing these new activities.

Resolution:

It is now not possible to submit a large claim if a prior submit is in process or errored. This ensures that the ongoing activity is completed before a new submit can be triggered. Now, only one restart link is displayed in the user interface allowing to recover the failed activity.

38100264

NXT-31878

Claim Line page does not load in transaction version

Description:

It is not possible to open claim line detail page in claims transaction version.

Resolution:

Details of claim lines are now displayed in Claim transaction version.

37892472

3-40434615271

NXT-31501

When a claim is unfinalized and submitted for 'Benefits Only', claim is always sent out for preprocessing.

Description:

When a claim is unfinalized and submitted by clicking 'Benefits Only' button, the claim is directly submitted without saving the claim with 'Preprocessing Done' and 'Pricing Done' indicators set to 'Yes'.

Resolution:

Claim is now submitted after it is saved with 'Preprocessing Done' and 'Pricing Done' indicators set to 'Yes', thereby not sending it out for preprocessing.

38065475

NXT-31817

End date of a reference sheet line cannot be cleared using PUT on referencesheetlines API

Description:

Clearing end date of a reference sheet line using PUT gives success response, but does not update the end date.

Resolution:

End date can be updated to "" correctly now.

37926328

NXT-31580

Claims in progress report- Pend description is shown as undefined in pend reason column

Description:

In operational reports 'Claims in progress', pend reason column is displayed "code, undefined" when description is not available.

Resolution:

Handled empty code and description scenarios

37965175

3-39436526471

NXT-31667

Issue with adding vaule to custom filed on the country regeion Table

Description:

The customer is using a custom field to link cities to a Region. Multiple cities can be linked to a Region. Many cities have already been linked. However, application does not allow new cities to be linked to a Region.

Resolution:

There is a mismatch in the database sequence "increment by" value and "allocationSize", which has been resolved with the latest installer zip, shipped with this patch.

37954185

NXT-31643

An incorrect display name appears in the coverages section of the claim benefits tab

Description:

In the Claim Benefits > Coverages section, the display name is incorrectly sourced from Claim Line Coverage instead of Coverage Label

Resolution:

Display name is now shown correctly in the Coverages section of the claim benefits tab.

37957087

NXT-31650

Flexcodes as label do not work while using displayLabel for dynamic record fields

Description:

The fields from dynamic record which are configured as labels are displayed correctly when value is provided. But on adding displayLabel attribute with specific value details, the labels disappear.

Resolution:

Labels are now displayed correctly when configured for flex codes in dynamic record fields with displayLabel attribute

37984592

NXT-31694

UserJET property does not expose login name, last login timestamp and default country information

Description:

userJET property exposes only displayName and id fields.

Resolution:

userJET property now exposes the user id, login name, display name, last login timestamp and default country of the logged-in user.

38025080

NXT-31746

Claims in Progress: Reset & search buttons should be aligned to left in Advanced Search

Description:

For the Operational Reporting page, like in Claims in Progress, the Reset and Search buttons in the Advanced Search panel should be left-aligned. Currently, they are right-aligned.

Resolution:

Fix added to align Reset and Search Button to the left in the Advanced Search Component in Operational Reporting Pages.

37995141

NXT-31713

Boilerplate text appears for Clear All link for single value non-time valid dynamic record fields

Description:

Boilerplate text appears in Clear All link for SNVTV dynamic record fields instead of value

Resolution:

Boilerplate value as "Clear All' is displayed now

37957250

NXT-31652

Boilerplate text code is being shown instead of the text value for dynamic records page

Description:

Boilerplate text code is being shown instead of the text value in detail page, configured for dynamic records. This issue occurs when a custom boilerplate is added as a title in floorplan tile

Resolution:

Boilerplate translations are done and proper text is displayed in UI

37894268

NXT-31513

Referencesheetline query API gives incorrect results when the same record field name is used in multiple reference sheets

Description:

Referencesheetline query API returns results from all the reference sheets which has the field usage name as passed in the query, where only the results from the resource mentioned in the URL are expected.

Resolution:

Referencesheetlines query api now works fine
* Usage name validation is done on all clauses in the query to check if usage name exists in OHI
* Search works fine now and returns only the results that are applicable for the resource mentioned in the endpoint.

38093794

3-38637505211

NXT-31866

Unable to search policy/person for member having apostrophe in the name.

Description:

Users are unable to search for a person or policy when the member’s name contains an apostrophe. For example, if the person’s last name is D' Souza, the API throws an error instead of returning the expected result.

Resolution:

User Interface handles apostrophe in search input and returns expected results. To configure filter, prefilter, prefilterList etc with apostrophe in the query expression, another apostrophe can be used as an escape character.

37964797

NXT-31666

In Apply Template drawer, search is not working for Pricing Section

Description:

When the Apply Template drawer opens, select Pricing Templates Record from the dropdown. Under 'Pricing Section Options' search for a record, the Search criteria is not getting applied

Resolution:

Users will be able to Search in pricing section in apply template drawer

38015386

NXT-31735

Performance degradation in activity processing due to the overhead caused by the heartbeat query

Description:

The 'cleanup_act_status' activity monitoring the heart-beat query on the activities table to fetch records with status as 'In Process', is experiencing performance issues. The query is currently executing a full table scan as the status field is not indexed, resulting in increased execution time.

Resolution:

The query is now optimized using the indexed column 'VIRTUAL_UNPROCESSED_STATUS', resulting in better performance.

38002328

NXT-31721

All the servers experience decline in performance after invoking dynamiclogic/invalidateall

Description:

The dynamiclogic/invalidateall integration point triggers a recompilation of all the dynamic logics across all the application servers. Since dynamic logic compilation is a resource-intensive process, this operation causes performance decline on all the servers.

Resolution:

Now dynamic logic is compiled on a single server, allowing other servers to reuse the compiled output. So the performance of the other servers are not impacted.

38066831

NXT-31819

Adjudication Limit Counters - Boilerplate issue for Applied Max under Limit consumptions section

Description:

Boilerplate is not translated for Applied Max under Limit consumptions section

Resolution:

Boilerplate value is shown for Applied Max.

Issues that were backported in previous Release / Patch

No backports.