Release Notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.20

This document contains the release notes for Oracle Health Insurance Claims Adjudication Patch 4.25.1.0.20.

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-33615

Enhance Claims in progress report to add out of the box fields.

This enhancement adds new columns to the Claims in Progress metadata: claim form, process type, payer, total covered amount, total retention amount, total allowed amount, and process category.

Documentation Links:
Operations Guide - Operational Reporting-Claims In Progress

NXT-34301

Extend generic APIs to fetch provider name for provider type of flexcodes

This enhancement makes it possible to fetch the provider Name field when the flex code type is Provider. With this change, the provider Name field can now be configured and displayed on user interface pages that use Provider-type flex codes.

In addition, Reference Sheet lines can now display the provider name when the field usage type is Provider.

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

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Breaking Changes

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Access Restrictions

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Bug Fixes

BugDB SR Internal Summary

39470116

NXT-34294

Diminishing Rates - When a record is updated with end date, 'Diminishing Rates Block' table shows block range as 'undefined' for all the records

Description:

On the Diminishing Rates page, while updating the Diminishing Rate Blocks tab, if we try to add/update the Diminishing Rate Block Sizes and Diminishing Rate Block Amounts tabs with an End Date, the Block Range is appearing as undefined.

Resolution:

The Block Range now correctly displays the range that is active for the current date based on its configured Start Date and End Date

39273889

NXT-34098

External Claims Data updates bypass access restrictions on settlement reasons

Description:

Users can update External Claims Data with a settlement reason that was access restricted and not available to them. This allows a finalized claim to be settled with an unauthorized settlement reason, or allow an existing restricted settlement reason to be removed by a user without the required access.

Resolution:

Only authorized users can assign, replace, or clear an access-restricted settlement reason on external claims data.

39463266

NXT-34285

Authorization screen shows authorizations for a different claim/member

Description:

When user clicks on the authorizations screen from Claims page on a claim that doesn’t have an auth, its shows all the authorizations for the claim which were linked to previous claim accessed.

Resolution:

Authorization information of claims is displayed properly without cache of previously opened claims

Issues that were backported in previous Release / Patch

No backports.