ZRGO005S: Group Association Codes Missing for Umbrella Procedures (Doc ID 2055573.1)

Last updated on SEPTEMBER 14, 2015

Applies to:

Oracle Health Insurance Policy Administration Data Marts - Version and later
Information in this document applies to any platform.


On : version, Load

If a procedure is covered by a umbrella and the umbrella is changed for another (somewhere in the year) than the group target codes of the last umbrella will not be included with the claims
that fall within the period of the latter umbrella

The group codes of the umbrella which is /was valid on the procedure day must be included in the claim by the ZRGO005S

The issue can be reproduced at will with the following steps:
1. Take a pharmaceutical supply covered by a umbrella.
2. Change the umbrella in the course of the year.
3. Read a claim in a treatment period after the unbrella change
4. Run full loadrun BI

The issue has the following business impact:
Erroneous reports


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