Overview
The following table provides an overview of the integration points that are available for exchanging data with OHI Enterprise Policy Administration:
Integration Point | Purpose | Inbound/Outbound | Realtime/Batch | Must Have or Optional |
---|---|---|---|---|
Access Tokens |
Returns OAuth2 access tokens |
Outbound |
Realtime |
Must Have when using OAuth |
Activity |
Start and monitor activities |
Inbound |
Realtime |
Must Have |
Attached Data |
Create or modify additional information related to the policy, without affecting its status or reprocessing the policy |
Inbound |
Realtime |
Optional |
Control Task Processing |
The "taskprocessing" resource can be used to:
|
Both |
Realtime |
|
Credentials |
Manage credentials |
Both |
Realtime |
Must Have when securing REST |
Current Properties |
Shows currently set properties and their values |
Outbound |
Realtime |
Optional |
Data File Set |
Uploading of files |
Inbound |
Both |
Must Have |
Data Replication of Persons |
Replicate changes in person data to Claims and/or Authorizations |
Outbound |
Batch |
Optional |
Enrollment Status Response |
Supply applications with realtime enrollment data |
Outbound |
Request |
Recommended |
Financial Message |
Send a notification message to an external system once all the financial messages for a financial transaction set are written to the data file |
Outbound |
Request |
Must Have |
Group Client Integration Point |
Create and update group clients and their group accounts |
Inbound |
Request |
Must Have |
Key Stores |
Configure key stores |
Both |
Realtime |
Optional |
Macros |
Receive macro requests |
Inbound |
Online Asynchronous |
Optional |
Note |
Retrieve, create and update notes |
Both |
Request |
|
Policy In |
Create and update policies |
Inbound |
Request |
Optional |
Policy Account |
Create and fetch policy accounts |
Inbound/Outbound |
Request |
Optional |
Policy Account Transaction |
Create and fetch a policy account transaction for a policy account |
Inbound/Outbound |
Request |
Optional |
Policy Account Transaction List |
Create a list of policy account transactions for a list of policy accounts |
Inbound |
Batch |
Optional |
Policy Enrollment Event |
Create policy enrollment events |
Inbound |
Request |
Optional |
Property Definitions |
Retrieve all available system property definitions |
Outbound |
Realtime |
Optional |
Provider In |
Create and update provider (individual, organization and group) information |
Inbound |
Both |
Optional |
Provisioning |
Provision OHI Enterprise Policy Administration with user and user roles |
Inbound |
Request |
Optional |
Quote |
Provide premium quotes to portals |
Outbound |
Request |
Must Have |
Reference Sheet Line |
Create, update and delete reference sheet lines |
Inbound |
Both |
Optional |
Registration |
Create and update payment and bill registrations |
Inbound |
Batch |
Optional |
Relation In |
Create and update relation (person and organizations) information |
Inbound |
Both |
Optional |
User Information |
Provides the ability to fetch the user information (user preferences, access restriction grants, etc.) and to update the user preferences of the logged in user |
Both |
Request |
Optional |
Dataexchange |
Allow the exchange of data sets between application environments without having to access the application screens. |
Both |
Request |
Must Have |
Validate Policy |
This operation provides the ability to validate a policy without submitting it |
Inbound |
Realtime |
Optional |
Submit a Policy for Processing |
This operation makes it possible to submit a policy for processing. |
Inbound |
Realtime |
Must Have |
Revert Policy to Previous Version |
This operation makes it possible to delete the latest policy version in the edit status and revert the policy to its previous version. |
Inbound |
Realtime |
Optional |
To Edit Operation for a Policy |
This operation makes it possible to bring the policy back to edit status |
Inbound |
Realtime |
Optional |
Run Example Calculation for a Policy |
This operation provides the ability to run premium calculation for a policy for a specific contract period or calculation period, without storing the results of the calculation. |
Inbound |
Realtime |
Optional |
Process and Apply Registrations to Periods |
This functionality makes it possible to apply payment registrations and determine the coverage period that can be considered to be paid for. |
Inbound |
Realtime |
Optional |
Sample Process and Apply Registrations to Periods |
This operation provides means to process and apply registrations to a policy with sample payment registrations |
Both |
Request |
Optional |
Run Calculation and Produce Invoice for a Policy |
This operation provides a convenient way to execute several steps involved in calculate premium and invoice generation in one go to produce |
Both |
Request |
Optional |
Run Calculation and Produce Sample Invoice for a Policy |
This operation provides a convenient way to execute several steps involved in calculate premium and invoice generation in one go to produce a sample invoice. |
Both |
Request |
Optional |
Create Mutation for a Policy |
Policy mutations can be triggered through this operation |
Inbound |
Realtime |
Optional |
Generate Fee and Produce Invoice for a Policy |
This Integration is used to genarate fee through policy mutations and then produce invoice. |
Both |
Request |
Optional |
Cancel Policy |
This operation provides the ability to cancel a policy |
Inbound |
Request |
Optional |
Purge Policy |
This operation completely removes a single policy and all of its details from the system. This operation is not intended to be used in production environment. |
Inbound |
Request |
Optional |
Cancel Policy and Produce Invoice |
This operation provides the ability to cancel a policy and immediately produce an invoice for the canceled policy |
Both |
Realtime |
Optional |
Extract Integration Point |
This integration point enables OHI Application(s) to do bulk data extraction. |
Inbound |
Batch |
Optional |
Group Hiearchy |
This operation returns the hierarchy of group configuration. |
Inbound |
Request |
Optional |
Invalidate Dynamic Logic Integration Point |
This integration point provides the ability to invalidate all the dynamic logic, in order to re-compile the groovy logic. |
Inbound |
Request |
Optional |
Get Calculation Cycles of a Policy |
This integration point provides an ability to get the next billing cycles for a policy. |
Inbound |
Request |
Optional |
Workflow Integration Point |
When a policy pends, the system sends out a workflow event to external system. |
Outbound |
Request |
Optional |
We recommend uploading files with sizes under 20 MB. Larger files impact the stability of the system. |
Details about individual integration points can be found in the Developer guide of Oracle Health Insurance Enterprise Policy Administration.