Classification Step Skipped in Case of Product Dependent Fatal Messages (Doc ID 2266780.1)

Last updated on MAY 16, 2017

Applies to:

Oracle Health Insurance Claims Adjudication - Version 2.16.1.0.0 and later
Information in this document applies to any platform.

Symptoms

On :  2.16.1.0.6 version, Processing
Acceptance


As per 2.15.1 implementation guide, CLASSIFICATION step be evaluated for Product dependent fatal messages, but this is not happening in version 2.16.1; the Classification step is not evaluated.

Note: this issue is reported when testing the following NXT:  NXT-13643
PC0024: CLASSIFICATION STEP PREVENTED IN CASE OF FATAL  DEPENDENT MESSAGES
Descr PC0024: Claim Classification . Requirement: The classification step is not executed if a product independent fatal message (of origin MANUAL, EXTERNAL, SANITY CHECKS, PRE PRICING or ENROLLMENT) exists that is attached to the claim line (directly or inherited) .

When there is a fatal product dependent message of origin Enrollment on the claim line. . Expected Result : Evaluate Classification . Actual Result : Skipping Evaluation

The issue can be reproduced at will by processing a claim with a product dependent fatal message

Changes

 

Cause

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