Bug 22150200: Beoordelingsregels Worden Dubbel Geteld In Dwh_declaratie_afhandeling Bij Inclusief (Doc ID 2081250.1)

Last updated on NOVEMBER 23, 2015

Applies to:

Oracle Health Insurance Claims Management Data Marts - Version 10.15.1.2 to 10.15.3.0 [Release 10.15]
Information in this document applies to any platform.

Symptoms

Description:
If an adjudication rule has as been set up in such a way that it must be applicable for 2 criteria, then this counts as 1 message. Due to the setup of dwh_declaratie_afhandeling (combination of adjudication rule and adjudication criterion) this counts as 2 messages. That causes an incorrect calculation of the number of times an adjudication rule occurs.

ENVIRONMENT
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Acceptance

ERROR
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If an adjudication rule has as been set up in such a way that it must be applicable for 2 criteria, then this counts as 1 message. Due to the setup of dwh_declaratie_afhandeling (combination of adjudication rule and adjudication criterion) this counts as 2 messages. That causes an incorrect calculation of the number of times an adjudication rule occurs.

EXPECTED BEHAVIOR
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If an adjudication rule has as been set up in such a way that it must be applicable for 2 criteria, then it should be counted as 1 message.

STEPS
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The issue can be reproduced at will with the following steps:
Set up an adjudication rule in such a way that it must be applicable for 2 criteria.
Handle a claim that is excepted because of those 2 criteria
Load dwh_declaratie_afhandeling

BUSINESS IMPACT
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The issue has the following business impact:
The count of number of messages is incorrect, so management information is incorrect as well

Cause

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