Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.2

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.2.

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-31355

Ability to update Claim Form

This enhancement introduces the ability to update claim form for an existing claim. This feature can be enabled by configuring system property 'ohi.claims.update.claimform.allow' to true.

Additional restrictions have been introduced in generic APIs to create or update claim lines such that only the procedure codes for the flex code system configured for the selected claim form can be used as the claim line procedures.

Note: Since the API request to retrieve the floorplan from JET user interface is cached at the browser and server to improve the application performance, there is a possibility of serving outdated floorplan data after the property change. To ensure the latest version of floorplan is picked up:

  • perform a floorplan update to clear the server-side cache

  • clear the browser cache to refresh the data and prevent stale responses.

Documentation Links:
Operations Guide

NXT-31595

Family Level Reserve Limits

This enhancements extends the existing reserve limit feature to also include family level limits.

POL-16056

Store Long Addresses

The character limit for the "Additional Address" fields has been increased from 60 to 250 characters. This change applies to the following fields:

  • ADDITIONAL PART 1

  • ADDITIONAL PART 2

  • ADDITIONAL PART 3

This update affects Relation Entities.

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

NXT-31355

Added

ohi.claims.update.claimform.allow

This property allows / not allows update on claim.claimForm for an existing claim. default value is 'false', which means update on claim form is not allowed

Web Services

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Data Conversion

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Dynamic Logic

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UI Changes

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Breaking Changes

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Bug Fixes

BugDB SR Internal Summary

37943474

3-37582942001

NXT-31616

Large chronicle queue files of size 180 GB are created by applicationDBAppender while capturing application log events.

Description:

The applicationDBAppender that captures the application log events in database generates a large chronicle queue files of size 180 GB on encountering an exception that gets re-queued in an end-less while loop.

Resolution:

The elements are not requeued to prevent an endless loop and to avoid increasing the queue file size.

37843400

3-40007142171

NXT-31430

Claims search does not expand dynamic fields on service provider

Description:

Search on claims using fields parameter does not expand dynamic fields on service provider

Resolution:

The search response on claims now ensures that all relevant dynamic fields are properly included based on the request parameters.

37843427

3-38637505211

NXT-31432

Query API returns error when the search criteria value contains an apostrophe.

Description:

When the query field string value contains an apostrophe ('), the query API returns a parsing error.

Resolution:

Query API now returns correct results even when search criteria contains apostrophes.

38224077

3-41573384621

NXT-32123

Claims: It is not allowed to do subsequent updates in Financial Transaction Process Data

Description:

When Financial Transaction Process Data is updated and saved, a subsequent update without closing the dialog results in optimistic lock exception. The page has to be refreshed before the second update to save it.

Resolution:

Financial Transaction Process Data now refreshes automatically after clicking save action

37924312

NXT-31572

User sequences cannot be migrated via configuration migration

Description:

Configuration Migration does not consider user sequences as a top level item in claims application

Resolution:

User Sequences can be migrated as a top level item now

38146859

NXT-31976

Claims In progress - Previously opened tab shows up instead of Claims page

Description:

When user clicks on claims deep link in 'In Claims In Progress' page, previously opened tab is shown instead of claims page

Resolution:

Before opening the claims deep link drawer, previously opened tab history is cleared and claim page is shown

37913986

3-40785062841

NXT-31549

On Mouse dragging action, the drawer closes abruptly

Description:

Performing a mouse drag action on the drawer closes it.

Resolution:

Dragging the mouse in the opposite direction won’t close the drawer unintentionally

37891228

3-40525941631

NXT-31497

Deny message on claim line does not affect toBeStatus of the claim line.

Description:

When the claim is adjudicated and a deny message gets attached to the claim line, toBeStatus of the claim line shows as 'to be approved'

Resolution:

A new custom label property toBeStatusJET has been introduced which can be added/removed from the floorplan as required. 'To Be Denied' label is now displayed if the claim or claimline message has severity 'Fatal' or 'Deny' with overturn set to false.

38223236

3-41585115051

NXT-32122

Labels for single value non time valid flexcode fields are not working while configuring it in search page

Description:

Labels are not displayed for single value non time valid flexcode fields in search page

Resolution:

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

38113665

NXT-31902

Tracking/Tracing of requests should not be sent to external systems

Description:

Tracking/Tracing of requests should not be sent to external systems Description of the bug: B3 Tracing headers are send to external systems such as OIC which responds with 500 stating add oic.service-instance property and if the spanId is removed from the headers the request responds with 201.

Resolution:

B3 Tracing headers will be added when the host of the request and the application are identical.

38102069

3-40519596161

NXT-31882

Claimline detail page hangs or slows down with 'Resolve' action in claimLinePendReason

Description:

The claimline detail page hangs or responds slowly when opening a claimline with pend reasons from a subclaim detail page of a large claim, due to the 'Resolve' action in claimLinePendReasonList. Additionally, the Unfinalize dialog is showing empty for large claims.

Resolution:

Claim line detail page does not slow down now when pend reasons have Resolve action on them. Also, unfinalize dialog now shows results for large claims.

38079633

NXT-31829

Added custom content-Length header (X-Content-Length) to the data file response for validation during file downloads in Oracle Integration Gateway

Description:

Enhance the getFileContents API in DataFile to include a custom response header X-Content-Length, allowing the calling application to verify if the full content has been received.

If there’s a mismatch or if the response header is missing (incase of partial response) , the application can retry the API to retrieve the complete content

Resolution:

To address the issues of incomplete or failed data file downloads in Oracle Insurance Gateway (OIG), content length validation has been implemented. This validation is triggered when OIG detects partial data by comparing the actual content length with the expected value provided in the custom response header "X-Content-Length". This header is now included in the claims data file response to enable accurate validation.

38147870

NXT-31980

View link on claim lines page does not move user to activities page

Description:

A view link comes on claim lines object navigation when the resolve pend activity has failed. Clicking on that link, user is not able to move to global activities page.

Resolution:

User can navigate to failed Activity page now

37978455

NXT-31680

Access restriction on dynamic field usage of type 'CODE' does not work

Description:

Access restriction on dynamic field usage of type 'CODE' does not work.

Resolution:

Create, Retrieve, Update and Delete operations on dynamic field usages of type 'CODE' work as expected now.

38060477

3-40519596161

NXT-31808

Claimline detail page is picking up a floorplan with different tag when configured as tab-table

Description:

When the claimline is configured as a tab-table, JET is picking up a floorplan with an incorrect tag instead of the tag specified on the Claim page. This only seems to happen when claimline is configured as tab-table but works fine when configured as tab-results. Large claim page also has the same issue.

Resolution:

Now, the floorplan with right tag is picked up as expected for claimline when configured as tab-table. The tagging functionality is working fine on LargeClaim, SubClaimsTab, SubClaims, Claimline when all of these refer to same 'tag'

38138023

NXT-31961

Claims gets reprocessed on click of cancel button in Confirm Reprocess Pop up

Description:

On clicking 'Reprocess' link on a claim that has processing error, a pop up with 'OK' and 'Cancel' is displayed to confirm the reprocess action. Reprocess happens even on click of cancel button.

Resolution:

Claims get reprocessed only on click of 'ok' button in confirm reprocess popup in Claims page.

38165053

3-41451926611

NXT-32044

Copy action is not working on 'Fee Schedule Lines' tab under Fee Schedules Page

Description:

On click of Copy action on any record, nothing happens in 'Fee Schedule Lines' tab

Resolution:

Copy feature is available on Fee Schedule Lines tab in Fee Schedules Page

38162480

3-41348495991

NXT-32031

Financial transaction overview is not showing 51st version

Description:

On claims page, when navigating via Financials link, the Financial transaction overview does not display data for 51st version.

Resolution:

Financial transaction overview now displays data for more than 50 rows and upto 200 records.

38142469

NXT-31971

Summary section of claim line is shown for other tabs

Description:

When navigating from the claim line to the "Pend Reasons" or "Messages" tabs, the summary section of the claim line remains visible in other tabs as well.

Resolution:

When navigating from the claim line tab to the 'Pend Reasons' or 'Messages' tabs, the summary section of the claim line is not visible in the other tabs and only additional fields are shown.

38002665

3-40799088818

NXT-31724

Numeric field search is not displayed in dropdown configured in lookup dialog

Description:

Search on number field like pincode is not displayed in lookup dialog. It is not retrieving any results

Resolution:

Number field search works fine and returns expected results in lookup dialog

38050635

3-40950562361

NXT-31785

Init/evaluate conditions are erratic while duplicating a claimline

Description:

Init/evaluate conditions are not working when a claimline is copied

Resolution:

Conditional checks will be validated when copying rows in the tab table.

38008524

NXT-31728

Count of records is displayed as '0' in the title of widgets when all the records are loaded

Description:

In Widgets, Count of records is displayed as '0' when user scrolls until all the records are loaded and no records are downloaded upon clicking download button

Resolution:

Total number of records is displayed in the count field now. Also, all the records loaded are now downloaded on clicking the download button.

38035839

3-40948058341

NXT-31769

Message text field is not available in Message Group Details tab

Description:

Message text field is not available in Message Group Details tab. Message text and severity for the table is missing.

Resolution:

Added message text and severity column in the table

38100312

NXT-31879

When a claim line is copied, claim Line sequence gets same value as copied line

Description:

Claim line sequence is copied when a user copies an existing claimline instead of showing next number

Resolution:

Claim line sequence is incremented and displayed when a user copies an existing claimline

Backports:

4.24.1.0.9

38153877

NXT-32007

Resolve Pend Reason and More dropdown at claim line tab level disappears when changing the claim to expanded view mode

Description:

When user switches from old view to expanded view mode, the options 'Resolve Pend Reason' and More dropdown disappear

Resolution:

Now both the Resolve Pend Reason and More dropdown is visible in expanded view mode.

37983042

3-40763288611

NXT-31685

Sorting is not working on the claim line tab when the tab is configured as results in the claims page

Description:

"Sort By" is not working for "tab-results" view in claimline tab in claims page. Records are not sorted based on the sort by value selected.

Resolution:

Records are sorted based on Sort By dropdown value when the Claim line tab is configured as “tab-results”

Issues that were backported in previous Release / Patch

BugDB Internal Summary Backport BugDB SR

38100312

NXT-31879

When a claim line is copied, claim Line sequence gets same value as copied line

4.24.1.0.9

38100328