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ER - Need Fourth Level on Combination Adjustment Rule (Doc ID 2300096.1)

Last updated on MARCH 28, 2019

Applies to:

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


Functionality to cater for a 4th level on the Combination Adjustment Rule is required; currently there are only 3 levels available, namely Primary, Secondary, and Tertiary.
Use case:
Level 1, pay at 100%
Level 2, pay at 75%
Level 3, pay at 50%
Level 4, pay at 25%

Without this functionality, some claims may not pay correctly.


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