Last updated on AUGUST 04, 2015
Applies to:Oracle Health Insurance Claims Management Data Marts - Version 10.14.2.4 and later
Information in this document applies to any platform.
On : 10.14.2.4.38 version, Load
This concerns a pharmacy EI claim which has been credited in a subsequent load-run.
The third line, which is created in the example is not correct. At least its is a problem in our data marts, because there are many details unknown.
For example, no brand product linked, the type of compensation is not known, collective number is gone, etc.
Also the aantal_regels_split (number_lines_split) and bedrag_gedeclareerd_split (amount_claimed_split) is not correct. (sum is now 1 line and amount claimed of 18.86, whereas both should have come to 0).
Only the 4th and 5th line would have to be sufficient to reverse the debit line.
The credit line that is recorded in Back Office ensures that the corresponding Debit line is cleared and gets a new date approved
This also falls within the load period and will be reloaded. Previously, such lines were not in the ETL process because there is no cover / details below.
Since we also load rejected claims , this is no longer a requirement, so these debit lines are also pasted again
The issue can be reproduced at will with the following steps:
1. Enter a load run from BO to DM, in which credit lines are included.
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