Operate, actions

Actions

Downstream actions derived from the resolved identities. Proposed actions wait for an operator; suppressed actions wait for a steward decision.

Eligibility engine
1,339
Eligibility conflict resolved
1,339 proposed
Claims processor
9,112
Orphan claim re-pointed
9,112 executed
Outreach
7,319
Outreach address corrected, Outreach suppressed pending steward
2,993 proposed4,326 held
Next-best-action
3,896
Care coordination outreach, New member onboarding
3,896 proposed
Member services
4,974
Duplicate member record retired
4,974 executed

Actions

26,640 derived from the last resolution run

TypeAllEligibility conflict resolved1,339Orphan claim re-pointed9,112Outreach address corrected2,993Outreach suppressed pending steward4,326Care coordination outreach1,815New member onboarding2,081Duplicate member record retired4,974
StatusAllProposed8,228Executed14,086Held4,326Released0
Duplicate member record retired, Member services, 0 proposed
ActionTypeTitleDetailLinked toStatusExecuted
ACT-026617
Duplicate member record retired
Member services
Judy Hawkins: 2 enrollment records collapsed into UHC-88988-21
Enrollment records
2
Member id
UHC-88988-21
MBR-045547
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026618
Duplicate member record retired
Member services
Joshua Simmons: 2 enrollment records collapsed into UHC-13424-53
Enrollment records
2
Member id
UHC-13424-53
MBR-045572
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026619
Duplicate member record retired
Member services
Jenifer Edwards: 2 enrollment records collapsed into UHC-36162-50
Enrollment records
2
Member id
UHC-36162-50
MBR-045601
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026620
Duplicate member record retired
Member services
Eric Bowman: 2 enrollment records collapsed into UHC-56333-05
Enrollment records
2
Member id
UHC-56333-05
MBR-045708
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026621
Duplicate member record retired
Member services
Henry Rios: 2 enrollment records collapsed into UHC-91003-95
Enrollment records
2
Member id
UHC-91003-95
MBR-045803
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026622
Duplicate member record retired
Member services
Jacqueline Robinson: 2 enrollment records collapsed into UHC-85264-95
Enrollment records
2
Member id
UHC-85264-95
MBR-045805
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026623
Duplicate member record retired
Member services
Daniel Dixon: 2 enrollment records collapsed into UHC-45004-55
Enrollment records
2
Member id
UHC-45004-55
MBR-045890
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026624
Duplicate member record retired
Member services
Roger Gonzalez: 2 enrollment records collapsed into UHC-13173-01
Enrollment records
2
Member id
UHC-13173-01
MBR-046029
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026625
Duplicate member record retired
Member services
Patrick Jacoobs: 2 enrollment records collapsed into UHC-46572-14
Enrollment records
2
Member id
UHC-46572-14
MBR-046036
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026626
Duplicate member record retired
Member services
Gregory Barnes: 2 enrollment records collapsed into UHC-73844-05
Enrollment records
2
Member id
UHC-73844-05
MBR-046085
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026627
Duplicate member record retired
Member services
Bradley Burton: 2 enrollment records collapsed into UHC-71453-79
Enrollment records
2
Member id
UHC-71453-79
MBR-046101
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026628
Duplicate member record retired
Member services
Alan Rice: 2 enrollment records collapsed into UHC-77693-50
Enrollment records
2
Member id
UHC-77693-50
MBR-046222
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026629
Duplicate member record retired
Member services
Nicholas Fisher: 2 enrollment records collapsed into UHC-15949-50
Enrollment records
2
Member id
UHC-15949-50
MBR-046228
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026630
Duplicate member record retired
Member services
Roger Castillo: 2 enrollment records collapsed into UHC-03372-25
Enrollment records
2
Member id
UHC-03372-25
MBR-046266
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026631
Duplicate member record retired
Member services
Nancy Freeman: 2 enrollment records collapsed into UHC-47450-44
Enrollment records
2
Member id
UHC-47450-44
MBR-046277
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026632
Duplicate member record retired
Member services
Bruce James: 2 enrollment records collapsed into UHC-10487-28
Enrollment records
2
Member id
UHC-10487-28
MBR-046286
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026633
Duplicate member record retired
Member services
Anna Armstrong: 2 enrollment records collapsed into UHC-13629-03
Enrollment records
2
Member id
UHC-13629-03
MBR-046300
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026634
Duplicate member record retired
Member services
Maria Wang: 2 enrollment records collapsed into UHC-42599-86
Enrollment records
2
Member id
UHC-42599-86
MBR-046338
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026635
Duplicate member record retired
Member services
Joe Vargas: 2 enrollment records collapsed into UHC-78473-84
Enrollment records
2
Member id
UHC-78473-84
MBR-046392
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026636
Duplicate member record retired
Member services
Shirley Dixon: 2 enrollment records collapsed into UHC-15098-65
Enrollment records
2
Member id
UHC-15098-65
MBR-046463
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026637
Duplicate member record retired
Member services
Willie Walsh: 2 enrollment records collapsed into UHC-23657-23
Enrollment records
2
Member id
UHC-23657-23
MBR-046507
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026638
Duplicate member record retired
Member services
Austin Hansen: 2 enrollment records collapsed into UHC-38354-03
Enrollment records
2
Member id
UHC-38354-03
MBR-046564
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026639
Duplicate member record retired
Member services
Walter Johnson: 2 enrollment records collapsed into UHC-73620-14
Enrollment records
2
Member id
UHC-73620-14
MBR-046606
Executed
resolution_agent
2026-10-22 12:47:23
ACT-026640
Duplicate member record retired
Member services
Joyce Olson: 2 enrollment records collapsed into UHC-61535-21
Enrollment records
2
Member id
UHC-61535-21
MBR-046626
Executed
resolution_agent
2026-10-22 12:47:23
4,974 rows, page 100 of 100PreviousNext

Derivation rules

Evaluated after every gold rebuild

  1. 1
    Eligibility conflict resolved
    The records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
  2. 2
    Orphan claim re-pointed
    A claim arrived without a member ID. Resolution attached it to an identity that has one, so the claims processor can now pay it against the right member.
  3. 3
    Outreach address corrected
    The most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
  4. 4
    Outreach suppressed pending steward
    The record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
  5. 5
    Care coordination outreach
    Three or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
  6. 6
    New member onboarding
    A single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
  7. 7
    Duplicate member record retired
    Two or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.