Persons Integration Point

When person details of members are primary maintained outside Oracle Health Insurance, Oracle Health Insurance needs an up-to-date copy of these details. The Person Integration Point enables external parties to create and maintain these copies.

Operations

This specific API supports the following operations

PUT

/persons creates or updates a person.

GET

/persons/{id} retrieves a person by its id.

The generic persons API supports, in addition to the standard generic API operations, the GET and the PATCH operation on /generic/persons/key/{key}. This enables retrieving and updating a person based on its code (the {key}).

To exclude the person covered services from the response, add the following header property with the URI:

header - excludeCoveredServices: true

Rules

Uniqueness

A person’s code is unique within the persons, organizations and banks in the application. A person’s identifier of a unique identifier type is unique within the persons, organizations and banks in the application.

Create or Update Behavior

The person code in combination with the identifier type drives whether the API creates a new person or updates an existing person is updated.

If the identifier type in the request is empty and the person code in the request matches the person code of an existing person, Oracle Health Insurance considers the details to be an update to that existing person.
If the combination of the identifier type and the person code in the request match the identifier type and value of an existing person, Oracle Health Insurance considers the details to be an update to that existing person.
If the identifier type in the request is empty and the person code in the request does not match the person code of an exiting person, Oracle Health Insurance adds a new person with the provided person code and details.

If the combination of the identifier type and the person code in the request does not match the identifier type and value of an existing person, Oracle Health Insurance adds a new person with a generated person code^[1] and stores the person code from the request as an identifier of the specified identifier type.
If the person code in the request is empty, Oracle Health Insurance adds a new person with a generated person code^[1].

Oracle Health Insurance enforces person codes to be unique across all relations, regardless of the source of the relation. However, identifier types can be non-unique. If the combination of the identifier type and the person code in the request matches multiple persons, the application returns error message REL-IP-RELA-027: "Multiple relations matched on identifier {identifier}" and does not update or create any person.

Request Messages

Each request message can contain the details of one person.

The details of exactly what information needs to be in a given request message varies based on factors such as whether details have been sent before and the category of details that have been added or updated.
For details on how values in the request messages are handled, refer Property Representation and Handling (PUT, POST, PATCH).

Person

The system accepts the person request message in the following format:

Person Request Message (click to open)

<person
  code=""
  identifierTypeCode=""
  name=""
  initials=""
  firstName=""
  gender=""
  genderIdentificationCode=""
  prefixCode=""
  suffix=""
  middleName=""
  nameFormatCode=""
  dateOfBirth=""
  dobInterpretation=""
  namePartner=""
  partnerPrefixCode=""
  phoneNumberBusiness=""
  phoneNumberMobile=""
  phoneNumberPrivate=""
  emailAddress1=""
  emailAddress2=""
  faxNumber=""
  outputLanguageCode=""
  preferredLanguageCode=""
  endDate=""
  accessRestrictionCode=""
  contactDetailsAccessRestrictionCode=""
>
  <relationIdentifierList>
    <relationIdentifier
      identifierTypeCode=""
      identifier=""
      enabled=""     />
  </relationIdentifierList>
  <relationLinkList>
    <relationLink
      relationLinkTypeCode=""
      direction=""
      relationCode=""
      enabled=""
    />
  </relationLinkList>
  <maritalStatusList>
    <maritalStatus
      maritalStatusTypeCode=""
      startDate=""
      endDate=""
    />
  </maritalStatusList>
  <personTitleList>
    <personTitle
      titleCode=""
    />
  </personTitleList>
  <addressList>
    <address
      addressTypeCode=""
      street=""
      houseNumber=""
      numberAddition=""
      additionalPart1=""
      additionalPart2=""
      additionalPart3=""
      city=""
      county=""
      stateAndCountyCode=""
      postalCode=""
      countryRegionCode=""
      countryCode=""
      startDate=""
      endDate=""
      accessRestrictionCode=""
    />
  </addressList>
  <bankAccounts>
    <bankAccount
      bankAccountNumber=""
      bankAccountNumberDebit=""
      bankCode=""
      bankAccountValidationCode=""
      specialName=""
      indPreferred=""
      startDate=""
      endDate=""
    />
  </bankAccounts>
  <relationTagList>
    <relationTag
      tagTypeCode=""
      startDate=""
      endDate=""
    />
  </relationTagList>
  <assignedProviderList>
    <assignedProvider
      providerAssignmentTypeCode=""
      startDate=""
      endDate=""
    >
      <provider
        code=""
        flexCodeDefinitionCode=""
     />
    </assignedProvider>
  </assignedProviderList>
  <personCoveredServiceList>
    <personCoveredService
      productCode=""
      serviceOptionServiceCode=""
      coveredServiceTierCode=""
      coveredServiceType=""
      score=""
      startDate=""
      endDate=""
      waitStartDate=""
      indWaiver=""
      waiverReason=""
    />
  </personCoveredServiceList>
  <contractAlignmentList>
    <contractAlignment
      capitationContractCode=""
      startDate=""
      endDate=""
    />
  </contractAlignmentList>
  <relationLobAccessRestrictionList>
    <relationLobAccessRestriction
      accessRestrictionCode=""
    />
  </relationLobAccessRestrictionList>
</person>

Authorization

This integration point requires a grant for access restriction Person In IP.

Response Messages

The Oracle Health Insurance application creates the response messages in response to request messages it receives from external interfaces. Please refer to the "Response Messages" section in the HTTP API/IP Concepts as part of the Developer Guide for more details.

Batches

This integration point supports the handling of multiple requests ('File Based Import') in one go. Please refer to the File Based Import page for more details.

Person

A person batch request message has the following structure:

<persons>
  <person/> -- refer to Person Request for details
</persons>

A person batch response message has the following structure:

<personsResponse>
  <resultMessages/>
</personsResponse>

Refer to the "Activity Integration Point" section in the HTTP API Integration Points part of the Developer Guide for more details. The elementId attribute that is included as part of the result messages element contains the code of the person for which the messages are raised.

Error Messages

The following error messages that are specific to the relation interface may be returned in the response messages:

Table 1. Error Messages
Code	Severity	Message
REL-IP-RELA-004	Fatal	Title code {code} is unknown
REL-IP-RELA-005	Fatal	Tag type code {code} is unknown
REL-IP-RELA-006	Fatal	Prefix code {code} is unknown
REL-IP-RELA-008	Fatal	Language code {code} is unknown
REL-IP-RELA-009	Fatal	Country code {code} is unknown
REL-IP-RELA-010	Fatal	Bank code {code} is unknown
REL-IP-RELA-011	Fatal	Bank account validation code {code} is unknown
REL-IP-RELA-012	Fatal	Country region code {code} is unknown
REL-IP-RELA-015	Fatal	Provider identified by code {code} and flex code definition code {code} is unknown
REL-IP-RELA-016	Fatal	Provider assignment type code {code} is unknown
REL-IP-RELA-017	Fatal	Capitation contract code {code} is unknown
REL-IP-RELA-018	Fatal	Identifier type code {code} is unknown
REL-IP-RELA-019	Fatal	Address type code {code} is unknown
REL-IP-RELA-020	Fatal	Gender identification code {code} is unknown
REL-IP-RELA-021	Fatal	Waiver reason code {code} is unknown
REL-IP-RELA-022	Fatal	Product code {code} is unknown
REL-IP-RELA-023	Fatal	Covered service tier code {code} is unknown
REL-IP-RELA-024	Fatal	There are pending changes to this person, updates not allowed
REL-IP-RELA-025	Fatal	Marital Status Type Code {code} is unknown
REL-IP-RELA-026	Fatal	Relation link type code {code} is unknown
REL-IP-RELA-027	Fatal	Multiple relations matched on identifier {identifier}

In addition, functional business rule messages may be returned as well as the standard messages related to dynamic fields and dynamic records. Refer to the Response Messages for more information.

1. Oracle Health Insurance generates a unique code by using a dynamic logic function of the signature 'Person Code Generation'. If no dynamic logic function with this signature exists, the code is set to the id.