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ER: Claims Update with Invalid Reference Data (Doc ID 2469287.1)

Last updated on NOVEMBER 05, 2018

Applies to:

Oracle Health Insurance Claims Adjudication - Version 3.18.1.0.0 and later
Information in this document applies to any platform.

Goal

ENHANCEMENT REQUEST:
=====================

ClaimsUpdate should function the same as ClaimsIn in regard to invalid procedure, diagnosis, member and provider. A claim will be created with claimsIn when these values are invalid. The invalid values are loaded but the field will fail sanity checks with the invalid data moved to the appropriate non-matched field. For a claimsUpdate the claim will not be updated (i.e. rejected at the door) and an IP error is returned.
 

Solution

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In this Document
Goal
Solution
References


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