Case Defintions

A case definition specifies the criteria by which a new case can be identified as well as closed. A case is essentially a bundling of related claim lines that do not necessarily belong to the same claim. A case definition defines when and how to recognize a new case and how to include claim lines in an existing case. The claim line that starts a new case is called a primary claim line, subsequent claim lines are called ancillary claim lines.

Case definitions are created and maintained in {prdclaimsponent}. The product building blocks integration point imports case definitions into Oracle Health Insurance Product Definition. In Oracle Health Insurance Product Definition a case definition only contains identifying attributes.

Field	Description
UUID	Unique identifier across OHI modules
Code	The code for this case definition
Description	The description of the case definition
Active Indicator	Indicator if the case definition can be used for benefit specifications

Case definitions do not have their own page in Oracle Health Insurance Product Definition and cannot be deleted or modified. A user has the option to select a case definition from a list of values when creating a service definition.