ZRG3004F: CLAIM ERROR F-DVW0296 INCORRECTLY CHANGED TO FATAL (Doc ID 2044789.1)

Last updated on OCTOBER 15, 2015

Applies to:

Oracle Health Insurance Claims Management - Version 10.14.2.4 and later
Information in this document applies to any platform.

Symptoms

On production: 10.14.2.4 version, Service

Testing M-4156

When attempting to process a claim in ZRG3004F for which a pre-authorization rule is applicable, and the claim flex field values do not entirely match the pre-authorization flex field values,
the following error occurs.

ERROR
-----------------------
'F'/'F' '0296' Flex field values of the pre-authorization procedure do not match those of the claim line.
The severity of the claim error has been incorrectly changed from overridable to fatal.

STEPS
-----------------------
The issue can be reproduced at will with the following steps:
1. ZRG1212F: Configure a benefit group with determining factors (flex field values) and a pre-authorization rule, for procedure X
2. ZRG3001F: Process a pre-authorization for procedure X, leaving the flex field values empty
3. ZRG3004F: Process claim for procedure X, having the flex field values filled out according the benefit group
4. ZRG3004F: Notice claim error 'F'/'F' '0296'

BUSINESS IMPACT
-----------------------
The issue has the following business impact:
Due to this issue, users cannot process the claim lines with a fatal error.

Cause

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