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ZRG3004f: Wrong Date Used To Retrieve The Norm Value (Doc ID 2106084.1)

Last updated on FEBRUARY 12, 2016

Applies to:

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


On acceptance: version, Usage

Processing a claim in ZRG3004F leads to incorrect outcome.

When a case is being created with a start date in 2016 for a member on a policy that has a contract period starting in 2015 the wrong Norm is being chosen to determine the deducible (threshold amount) and suma asegurada (maximum insured amount).
Instead of the start date of the case, the start date of the contract period is being used.

Use the start date of the case (when a case is involved) or the start date of the claim line (when there is no case involved) to determine the Norm.

The issue can be reproduced at will with the following steps:
1. ZRG3081F: Process case
2. Process claim in ZRG3004F

The issue has the following business impact:
Until the policies are being renewed with a contract period in 2016, this situation will appear.


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