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Issues with Policy Account on Adding or Deleting a Line to a Finalized Claim (Doc ID 2938410.1)

Last updated on APRIL 11, 2023

Applies to:

Oracle Health Insurance Enterprise Policy Administration - Version 3.22.1.0.0 and later
Information in this document applies to any platform.

Goal

Policy Account screen does not reflect correctly for the scenarios like adding a new claim line or deleting an existing claim line to a finalized claim.

1. Deleting a Claim Line Scenario:
When a claim line is deleted and claim is finalized, the existing policy account transaction for that claim line is not reversed. Client had to manually reverse the respective policy account transaction.

2. Adding a Claim Line Scenario:
Policy Account Balance is utilized for the Claim Processing. Issue occurs when a new line is added to an already finalized claim, which has entries in the PAT (Policy Account Transaction) screen with an updated balance.

Solution

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In this Document
Goal
Solution


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