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Limit Is Taken Before Coverage Calculation (Doc ID 2682703.1)

Last updated on JUNE 24, 2020

Applies to:

Oracle Health Insurance Claims Adjudication - Version 3.19.3.0.0 and later
Information in this document applies to any platform.

Symptoms

On : 3.19.3.0.0 version, User Interface

ACTUAL BEHAVIOR
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Within a coverage regime on the cover withhold rule , coverage is calculated by an input coverage label.
On the same line there is a cover limit on the cover withhold category.

The calculated value supplied by the input coverage label (RECOVERY) is handled correctly and sets the coverage.
However the limit on the coverage is already taken before the calculated value applies.

Cause

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In this Document
Symptoms
Cause
Solution


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