Oracle® Insurance Rules Palette
This feature provides the ability in OIPA to store various Services for which coverages/benefit values can be defined. It provides a provision for hierarchical grouping of the services described above called Service Group.Benefits and are defined for the services for each segment.
N/A
ServiceGroupCategoryCode
01 Medical 02 Dental 03 Vision 04 Pharmacy 05 Accidents 06 Supplemental
ServiceStatusCode
01 New 02 Pending 03 Pending Approval 04 Expired
ServiceLevel
01 All 02 Facility 03 Professional
ServiceGroup Table
ServiceGroupDescription ServiceGroupCode ServiceGroupCategoryCode Diagnostic and Preventive Services GPA 2 Vision Exam VEA 3 Lenses VLA 3 Contact Lenses PLKM 3 General (Adjunctive) Services POLK 2
Service Table
ServiceCode ServiceDescription ServiceGroupCategoryCode OVA Oral Evaluation 3 XRY XRAY 3 UYT Cleaning 3 OPI Space Maintainers 3 VEAB Vision Exam 3 KPLM Single Vision 3 HJUK Bifoccal 3 PUYT Progressive 3 TRER TriFocal 3 NMBV Elective 3 XCVF Non elective 3 GMP General anesthesia 3 EMT Emergency palliative treatment 3 JKL Consultations 3
None
Copyright © 2009, 2015, Oracle and/or its affiliates. All rights reserved. Legal Notices