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-023717
Duplicate member record retired
Member services
Nicole Maldonado: 2 enrollment records collapsed into UHC-16949-67
Enrollment records
2
Member id
UHC-16949-67
MBR-013394
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023718
Duplicate member record retired
Member services
Nick Harrison: 3 enrollment records collapsed into UHC-96747-20
Enrollment records
3
Member id
UHC-96747-20
MBR-013396
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023719
Duplicate member record retired
Member services
Ralph Peters: 2 enrollment records collapsed into UHC-65331-99
Enrollment records
2
Member id
UHC-65331-99
MBR-013397
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023720
Duplicate member record retired
Member services
Barbara Marquez: 2 enrollment records collapsed into UHC-40992-91
Enrollment records
2
Member id
UHC-40992-91
MBR-013399
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023721
Duplicate member record retired
Member services
Eric Barnes: 2 enrollment records collapsed into UHC-25921-67
Enrollment records
2
Member id
UHC-25921-67
MBR-013407
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023722
Duplicate member record retired
Member services
Lucia Tucker: 2 enrollment records collapsed into UHC-39477-43
Enrollment records
2
Member id
UHC-39477-43
MBR-013411
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023723
Duplicate member record retired
Member services
Ashley Fields: 2 enrollment records collapsed into UHC-74750-45
Enrollment records
2
Member id
UHC-74750-45
MBR-013416
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023724
Duplicate member record retired
Member services
Betty Garcia: 3 enrollment records collapsed into UHC-86761-69
Enrollment records
3
Member id
UHC-86761-69
MBR-013420
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023725
Duplicate member record retired
Member services
Walter Roberts: 2 enrollment records collapsed into UHC-32804-90
Enrollment records
2
Member id
UHC-32804-90
MBR-013425
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023726
Duplicate member record retired
Member services
Teresa Knight: 2 enrollment records collapsed into UHC-05402-97
Enrollment records
2
Member id
UHC-05402-97
MBR-013427
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023727
Duplicate member record retired
Member services
Priya Coleman: 2 enrollment records collapsed into UHC-29997-83
Enrollment records
2
Member id
UHC-29997-83
MBR-013436
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023728
Duplicate member record retired
Member services
Denise Yang: 3 enrollment records collapsed into UHC-29623-83
Enrollment records
3
Member id
UHC-29623-83
MBR-013470
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023729
Duplicate member record retired
Member services
Bradley Marquez: 2 enrollment records collapsed into UHC-30238-54
Enrollment records
2
Member id
UHC-30238-54
MBR-013477
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023730
Duplicate member record retired
Member services
Mariana Herrera: 2 enrollment records collapsed into UHC-47508-09
Enrollment records
2
Member id
UHC-47508-09
MBR-013480
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023731
Duplicate member record retired
Member services
Jeffrey Moore: 2 enrollment records collapsed into UHC-66663-74
Enrollment records
2
Member id
UHC-66663-74
MBR-013488
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023732
Duplicate member record retired
Member services
Brandon Fox: 2 enrollment records collapsed into UHC-96771-85
Enrollment records
2
Member id
UHC-96771-85
MBR-013494
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023733
Duplicate member record retired
Member services
William McDonald: 2 enrollment records collapsed into UHC-29786-39
Enrollment records
2
Member id
UHC-29786-39
MBR-013499
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023734
Duplicate member record retired
Member services
Gary Burke: 2 enrollment records collapsed into UHC-88412-98
Enrollment records
2
Member id
UHC-88412-98
MBR-013517
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023735
Duplicate member record retired
Member services
Dylan Maldonado: 2 enrollment records collapsed into UHC-83801-46
Enrollment records
2
Member id
UHC-83801-46
MBR-013520
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023736
Duplicate member record retired
Member services
Pamela Ruiz: 2 enrollment records collapsed into UHC-62098-03
Enrollment records
2
Member id
UHC-62098-03
MBR-013526
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023737
Duplicate member record retired
Member services
Ryan Walker: 2 enrollment records collapsed into UHC-79552-94
Enrollment records
2
Member id
UHC-79552-94
MBR-013529
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023738
Duplicate member record retired
Member services
Daniel Walker: 3 enrollment records collapsed into UHC-12416-79
Enrollment records
3
Member id
UHC-12416-79
MBR-013541
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023739
Duplicate member record retired
Member services
Doris Day: 2 enrollment records collapsed into UHC-85943-20
Enrollment records
2
Member id
UHC-85943-20
MBR-013552
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023740
Duplicate member record retired
Member services
Andrea Bishop: 2 enrollment records collapsed into UHC-45947-89
Enrollment records
2
Member id
UHC-45947-89
MBR-013555
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023741
Duplicate member record retired
Member services
Benjamin Carr: 2 enrollment records collapsed into UHC-31487-44
Enrollment records
2
Member id
UHC-31487-44
MBR-013559
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023742
Duplicate member record retired
Member services
Kevin Roberts: 2 enrollment records collapsed into UHC-76083-04
Enrollment records
2
Member id
UHC-76083-04
MBR-013562
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023743
Duplicate member record retired
Member services
Richard Wright: 2 enrollment records collapsed into UHC-10330-79
Enrollment records
2
Member id
UHC-10330-79
MBR-013572
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023744
Duplicate member record retired
Member services
Ronald Alvarez: 2 enrollment records collapsed into UHC-65432-23
Enrollment records
2
Member id
UHC-65432-23
MBR-013576
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023745
Duplicate member record retired
Member services
Kelly Richards: 2 enrollment records collapsed into UHC-61615-48
Enrollment records
2
Member id
UHC-61615-48
MBR-013589
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023746
Duplicate member record retired
Member services
Aisha Lopez: 2 enrollment records collapsed into UHC-33764-63
Enrollment records
2
Member id
UHC-33764-63
MBR-013594
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023747
Duplicate member record retired
Member services
Nick Hanson: 2 enrollment records collapsed into UHC-25262-89
Enrollment records
2
Member id
UHC-25262-89
MBR-013604
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023748
Duplicate member record retired
Member services
Patricia Robertson: 3 enrollment records collapsed into UHC-63151-88
Enrollment records
3
Member id
UHC-63151-88
MBR-013608
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023749
Duplicate member record retired
Member services
Isabella Price: 3 enrollment records collapsed into UHC-41557-49
Enrollment records
3
Member id
UHC-41557-49
MBR-013620
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023750
Duplicate member record retired
Member services
Christopher Davis: 3 enrollment records collapsed into UHC-15407-27
Enrollment records
3
Member id
UHC-15407-27
MBR-013629
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023751
Duplicate member record retired
Member services
Kelly Hudson: 2 enrollment records collapsed into UHC-39251-23
Enrollment records
2
Member id
UHC-39251-23
MBR-013635
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023752
Duplicate member record retired
Member services
Megan Simpson: 2 enrollment records collapsed into UHC-32074-70
Enrollment records
2
Member id
UHC-32074-70
MBR-013636
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023753
Duplicate member record retired
Member services
Jacob Mills: 2 enrollment records collapsed into UHC-03929-94
Enrollment records
2
Member id
UHC-03929-94
MBR-013638
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023754
Duplicate member record retired
Member services
Eugene Watkins: 2 enrollment records collapsed into UHC-86450-26
Enrollment records
2
Member id
UHC-86450-26
MBR-013651
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023755
Duplicate member record retired
Member services
Alice Ford: 2 enrollment records collapsed into UHC-51724-46
Enrollment records
2
Member id
UHC-51724-46
MBR-013665
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023756
Duplicate member record retired
Member services
Martha Campbell: 2 enrollment records collapsed into UHC-49054-08
Enrollment records
2
Member id
UHC-49054-08
MBR-013667
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023757
Duplicate member record retired
Member services
Linda Moore: 2 enrollment records collapsed into UHC-65655-62
Enrollment records
2
Member id
UHC-65655-62
MBR-013675
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023758
Duplicate member record retired
Member services
Doris West: 2 enrollment records collapsed into UHC-24341-03
Enrollment records
2
Member id
UHC-24341-03
MBR-013691
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023759
Duplicate member record retired
Member services
Denise Cooper: 2 enrollment records collapsed into UHC-73125-42
Enrollment records
2
Member id
UHC-73125-42
MBR-013692
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023760
Duplicate member record retired
Member services
Kayla Cole: 3 enrollment records collapsed into UHC-96523-84
Enrollment records
3
Member id
UHC-96523-84
MBR-013700
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023761
Duplicate member record retired
Member services
David Graham: 2 enrollment records collapsed into UHC-28829-66
Enrollment records
2
Member id
UHC-28829-66
MBR-013708
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023762
Duplicate member record retired
Member services
Jesse Pena: 2 enrollment records collapsed into UHC-04366-25
Enrollment records
2
Member id
UHC-04366-25
MBR-013722
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023763
Duplicate member record retired
Member services
Amber Li: 3 enrollment records collapsed into UHC-49748-88
Enrollment records
3
Member id
UHC-49748-88
MBR-013742
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023764
Duplicate member record retired
Member services
Cruz Paul: 2 enrollment records collapsed into UHC-90990-14
Enrollment records
2
Member id
UHC-90990-14
MBR-013769
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023765
Duplicate member record retired
Member services
Denise Vargas: 2 enrollment records collapsed into UHC-01600-93
Enrollment records
2
Member id
UHC-01600-93
MBR-013772
Executed
resolution_agent
2026-10-22 12:47:23
ACT-023766
Duplicate member record retired
Member services
Lauren Murphy: 3 enrollment records collapsed into UHC-46397-91
Enrollment records
3
Member id
UHC-46397-91
MBR-013779
Executed
resolution_agent
2026-10-22 12:47:23
4,974 rows, page 42 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.