View Benefit Specifications
This page displays all the benefit specifications existing within Oracle Health Insurance Product Definition. Through this page it is possible to update the generated description of a benefit specification and to purge any unused benefit specifications.
The page is accessed though the Products menu, under the sub-menu item Products, with the link "Benefit Specifications".
The page is represented as a single table and each row displays the following attributes and details of a benefit specification:
-
Code
-
Description, editable text field.
-
The type of the benefit specification
-
Service Definition
-
Procedure Group; displays the procedure group and its scope
-
Procedure Group 2; displays the procedure group and its scope
-
Procedure Group 3; displays the procedure group and its scope
-
Procedure Condition; displays the procedure condition and its scope
-
Diagnosis Usage
-
Diagnosis Group
-
Diagnosis Condition
-
Diagnosis Type
-
Product; displays the product provider group scope
-
Specific Networks; displays multiple groups (including assignment labels) and their scope
-
Regime
-
Auth. (Authorization) Missing?
-
Consume Auth. (Authorization)?
-
Case Definition
-
Claim Form Type
-
Modifiers; displays multiple modifiers and their scope
-
Specialties; displays multiple specialties and their scope
-
Location Types; displays multiple location types and their scope
-
Conditions; displays multiple conditions
-
Empl. (Employer) Usage
-
Employer Country Region
-
Employer Country Region Group
-
Pers. (Person) Usage
-
Person Country Region
-
Person Country Region Group
-
Prov. (Provider) Usage
-
Provider Country Region
-
Provider Country Region Group
-
Age From
-
Age To
-
Gender
-
Priority
-
Active?
Any dynamic fields defined for the benefit specification appear in the page.
This page allows the user to use both the advanced and the quick search on several details of the benefit specification. For example, the user can search on all benefit specifications that contain a specific (combination of) condition(s). The following details are included in the search functionality:
-
Specific Networks
-
Conditions
-
Modifiers
-
Specialties
-
Location Types
The page also allows the user to search for empty values (e.g. benefit specifications without a modifier). The following fields allow for searching on empty values:
-
Modifiers
-
Specialties
-
Location Types
-
Employer Country Region / Employer Country Region Group
-
Person Country Region / Person Country Region Group
-
Provider Country Region / Provider Country Region Group
Purge Functionality
Benefit specifications cannot be deleted directly. To delete unused benefit specifications a purge functionality is provided. This feature will delete all unused benefit specifications, meaning benefit specifications for which no product benefit specification exists. The function is triggered with the "Purge Benefit Specification" button.
Note that whenever this process is running the view benefit specifications page is immutable (view only), with a "Purge in progress. Benefit specifications cannot be edited now." message informing the user about the state of the page. After the process is done the page is refreshed, reactivating the page. The purge action can only be executed when no unsaved changes exist on the page.