Provider Group Removed from Product in Prod Definition Still Showing in Claims (Doc ID 2079313.1)

Last updated on OCTOBER 16, 2016

Applies to:

Oracle Health Insurance Product Definition - Version 2.14.2 and later
Oracle Health Insurance Claims Adjudication - Version 2.14.2 and later
Information in this document applies to any platform.

Symptoms

On: 2.14.2.0.4 of Prod Def and 2.14.2.0.13 Claims Adjudication

ACTUAL BEHAVIOR
---------------
The page Product Provider Groups in Claims still shows the Provider Groups that are removed from the Product in Product Definition.

EXPECTED BEHAVIOR
-----------------------
The Provider Groups removed from the product should be removed when the product is loaded in Claims.

STEPS
-----------------------
The issue can be reproduced at will with the following steps:

A: Product Definition
Add provider groups to the product and create xml file to import in claims.

1.
NAV Products / Products / Overview
Query product to test with (Product X).
Under button Product select Provider Groups.
Add 2 or more Provider Groups (Group A and B for instance), and enter a start date.
Click OK. Click Save. Click Review. Click Test. Click Approve.
2.
NAV Operations / Data Exchanges / Product Export Sets
Create a set for the product to test with.
3.
NAV Operations / Data Exchanges / Outbound Data Sets
Select Products
Under Available Data Sets select the export set from 2, select Build File.
Save file.


B: Claims
Import the xml file and verify the provider groups in the product.

1.
NAV Operations / Data Exchanges / Inbound Data Sets
Select products
Under File Imports select the xml file and import.
2.
NAV Reference Data / Products / Product Provider Groups
Query your product (Product X).
This shows all provider groups (Group A and B).


C: Product Definition
Remove one provider group and create xml file to import in claims.

1.
NAV Products / Products / Overview
Query product. Click on Edit.
Under button Product select Provider Groups.
Remove Group A with the red X.
Click OK. Click Save. Review. Test. Approve.
2.
NAV Operations / Data Exchanges / Outbound Data Sets
Select Products
Under Available Data Sets select Build File
Save file.


D: Claims
Import xml file and verify that provider group is not removed.

1.
NAV Operations / Data Exchanges / Inbound Data Sets
Select products
Under File Imports select file and import.
2.
NAV Reference Data / Products / Product Provider Groups
Query product.
Provider group Group A still shows in the list, though it is not available in the file.



Cause

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