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Resolve Pend And Submit API Causes Unresolved Pends To Be Accepted (Doc ID 2747492.1)

Last updated on FEBRUARY 01, 2021

Applies to:

Oracle Health Insurance Claims Adjudication - Version 3.20.2.0.0 and later
Information in this document applies to any platform.

Symptoms

On : 3.20.2.0.0 version, Integration Points

ACTUAL BEHAVIOR
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Resolving pends using Resolve Pend API and Pend Resolution IP are not working as expected according to the documentation. Using the Submit API, unresolved Pend Reasons are accepted that should not be.

Using Resolve Pend and Submit API OHI resolved even the unresolved pend reasons and finalized the claim.

According to the guide it shouldn’t Finalize. See below. I have also tested using Pend Resolution IP which is exactly doing what we need but intended to use for batch purpose.

We believe this was functioning as expected in prior releases.

Cause

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In this Document
Symptoms
Cause
Solution
References


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