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-024017
Duplicate member record retired
Member services
Dennis Simmons: 2 enrollment records collapsed into UHC-42851-62
Enrollment records
2
Member id
UHC-42851-62
MBR-015499
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024018
Duplicate member record retired
Member services
Patrick Gutierrez: 2 enrollment records collapsed into UHC-40734-68
Enrollment records
2
Member id
UHC-40734-68
MBR-015510
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024019
Duplicate member record retired
Member services
Diego Ferguson: 2 enrollment records collapsed into UHC-88489-23
Enrollment records
2
Member id
UHC-88489-23
MBR-015521
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024020
Duplicate member record retired
Member services
Roger Carroll: 2 enrollment records collapsed into UHC-21603-47
Enrollment records
2
Member id
UHC-21603-47
MBR-015528
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024021
Duplicate member record retired
Member services
Mariana Nelson: 2 enrollment records collapsed into UHC-45506-94
Enrollment records
2
Member id
UHC-45506-94
MBR-015539
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024022
Duplicate member record retired
Member services
Sharon Hill: 2 enrollment records collapsed into UHC-93224-49
Enrollment records
2
Member id
UHC-93224-49
MBR-015540
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024023
Duplicate member record retired
Member services
Wayne Reed: 2 enrollment records collapsed into UHC-80993-98
Enrollment records
2
Member id
UHC-80993-98
MBR-015546
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024024
Duplicate member record retired
Member services
Melissa Hudson: 2 enrollment records collapsed into UHC-49229-90
Enrollment records
2
Member id
UHC-49229-90
MBR-015560
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024025
Duplicate member record retired
Member services
Amy Mills: 2 enrollment records collapsed into UHC-26865-47
Enrollment records
2
Member id
UHC-26865-47
MBR-015561
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024026
Duplicate member record retired
Member services
Brittany Hill: 2 enrollment records collapsed into UHC-99503-13
Enrollment records
2
Member id
UHC-99503-13
MBR-015562
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024027
Duplicate member record retired
Member services
Priya Duncan: 2 enrollment records collapsed into UHC-97186-66
Enrollment records
2
Member id
UHC-97186-66
MBR-015568
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024028
Duplicate member record retired
Member services
Madison Johnson: 2 enrollment records collapsed into UHC-26396-77
Enrollment records
2
Member id
UHC-26396-77
MBR-015569
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024029
Duplicate member record retired
Member services
Gabriel Freeman: 2 enrollment records collapsed into UHC-08406-34
Enrollment records
2
Member id
UHC-08406-34
MBR-015573
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024030
Duplicate member record retired
Member services
Diana Jacobs: 2 enrollment records collapsed into UHC-46306-19
Enrollment records
2
Member id
UHC-46306-19
MBR-015575
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024031
Duplicate member record retired
Member services
Peter Crawford: 2 enrollment records collapsed into UHC-41292-09
Enrollment records
2
Member id
UHC-41292-09
MBR-015585
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024032
Duplicate member record retired
Member services
Terry Meyer: 2 enrollment records collapsed into UHC-08100-59
Enrollment records
2
Member id
UHC-08100-59
MBR-015598
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024033
Duplicate member record retired
Member services
Anna Weaver: 2 enrollment records collapsed into UHC-31781-97
Enrollment records
2
Member id
UHC-31781-97
MBR-015602
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024034
Duplicate member record retired
Member services
Joyec Marshall: 2 enrollment records collapsed into UHC-07317-76
Enrollment records
2
Member id
UHC-07317-76
MBR-015608
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024035
Duplicate member record retired
Member services
Randy Alvarado: 2 enrollment records collapsed into UHC-90506-58
Enrollment records
2
Member id
UHC-90506-58
MBR-015611
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024036
Duplicate member record retired
Member services
Natalie Johnston: 2 enrollment records collapsed into UHC-96613-08
Enrollment records
2
Member id
UHC-96613-08
MBR-015614
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024037
Duplicate member record retired
Member services
Mike Simpson: 2 enrollment records collapsed into UHC-64894-03
Enrollment records
2
Member id
UHC-64894-03
MBR-015615
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024038
Duplicate member record retired
Member services
Carl Hall: 2 enrollment records collapsed into UHC-05485-85
Enrollment records
2
Member id
UHC-05485-85
MBR-015618
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024039
Duplicate member record retired
Member services
Deborah Harper: 2 enrollment records collapsed into UHC-63588-98
Enrollment records
2
Member id
UHC-63588-98
MBR-015621
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024040
Duplicate member record retired
Member services
Jonathan Rivera: 2 enrollment records collapsed into UHC-42719-76
Enrollment records
2
Member id
UHC-42719-76
MBR-015624
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024041
Duplicate member record retired
Member services
Jason Ford: 2 enrollment records collapsed into UHC-76473-51
Enrollment records
2
Member id
UHC-76473-51
MBR-015626
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024042
Duplicate member record retired
Member services
Ahmed Kelly: 2 enrollment records collapsed into UHC-98117-22
Enrollment records
2
Member id
UHC-98117-22
MBR-015638
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024043
Duplicate member record retired
Member services
Beverly Cunningham: 2 enrollment records collapsed into UHC-32494-13
Enrollment records
2
Member id
UHC-32494-13
MBR-015646
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024044
Duplicate member record retired
Member services
Nathan Cole: 2 enrollment records collapsed into UHC-77282-78
Enrollment records
2
Member id
UHC-77282-78
MBR-015651
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024045
Duplicate member record retired
Member services
Albert Lucas: 2 enrollment records collapsed into UHC-51902-38
Enrollment records
2
Member id
UHC-51902-38
MBR-015661
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024046
Duplicate member record retired
Member services
Jose Medina: 2 enrollment records collapsed into UHC-85752-84
Enrollment records
2
Member id
UHC-85752-84
MBR-015668
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024047
Duplicate member record retired
Member services
Betty Daniels: 2 enrollment records collapsed into UHC-73612-80
Enrollment records
2
Member id
UHC-73612-80
MBR-015672
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024048
Duplicate member record retired
Member services
Kathryn Schmidt: 2 enrollment records collapsed into UHC-54467-52
Enrollment records
2
Member id
UHC-54467-52
MBR-015675
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024049
Duplicate member record retired
Member services
Jacob Rios: 2 enrollment records collapsed into UHC-73234-71
Enrollment records
2
Member id
UHC-73234-71
MBR-015687
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024050
Duplicate member record retired
Member services
Alice Daniels: 3 enrollment records collapsed into UHC-83756-81
Enrollment records
3
Member id
UHC-83756-81
MBR-015698
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024051
Duplicate member record retired
Member services
Margaret McCoy: 2 enrollment records collapsed into UHC-88924-63
Enrollment records
2
Member id
UHC-88924-63
MBR-015706
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024052
Duplicate member record retired
Member services
Laura Ellis: 2 enrollment records collapsed into UHC-84006-39
Enrollment records
2
Member id
UHC-84006-39
MBR-015707
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024053
Duplicate member record retired
Member services
Samantha Washington: 3 enrollment records collapsed into UHC-17963-87
Enrollment records
3
Member id
UHC-17963-87
MBR-015719
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024054
Duplicate member record retired
Member services
Patrick Santiago: 2 enrollment records collapsed into UHC-62144-49
Enrollment records
2
Member id
UHC-62144-49
MBR-015738
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024055
Duplicate member record retired
Member services
Hiroshi Schultz: 2 enrollment records collapsed into UHC-49624-39
Enrollment records
2
Member id
UHC-49624-39
MBR-015745
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024056
Duplicate member record retired
Member services
Michael Wells: 3 enrollment records collapsed into UHC-80844-55
Enrollment records
3
Member id
UHC-80844-55
MBR-015749
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024057
Duplicate member record retired
Member services
Aisha Peterson: 2 enrollment records collapsed into UHC-50378-82
Enrollment records
2
Member id
UHC-50378-82
MBR-015750
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024058
Duplicate member record retired
Member services
Bruce Graham: 2 enrollment records collapsed into UHC-36934-07
Enrollment records
2
Member id
UHC-36934-07
MBR-015752
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024059
Duplicate member record retired
Member services
Jason Gordon: 2 enrollment records collapsed into UHC-52450-28
Enrollment records
2
Member id
UHC-52450-28
MBR-015755
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024060
Duplicate member record retired
Member services
Marcus Luna: 2 enrollment records collapsed into UHC-01356-25
Enrollment records
2
Member id
UHC-01356-25
MBR-015761
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024061
Duplicate member record retired
Member services
Andrea Carter: 2 enrollment records collapsed into UHC-34846-11
Enrollment records
2
Member id
UHC-34846-11
MBR-015780
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024062
Duplicate member record retired
Member services
Natalie Collins: 2 enrollment records collapsed into UHC-61521-40
Enrollment records
2
Member id
UHC-61521-40
MBR-015781
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024063
Duplicate member record retired
Member services
Albert Harrison: 2 enrollment records collapsed into UHC-16381-51
Enrollment records
2
Member id
UHC-16381-51
MBR-015785
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024064
Duplicate member record retired
Member services
Doris Tucker: 3 enrollment records collapsed into UHC-44970-38
Enrollment records
3
Member id
UHC-44970-38
MBR-015799
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024065
Duplicate member record retired
Member services
Michelle Riley: 2 enrollment records collapsed into UHC-95909-02
Enrollment records
2
Member id
UHC-95909-02
MBR-015800
Executed
resolution_agent
2026-10-22 12:47:23
ACT-024066
Duplicate member record retired
Member services
Priya Pena: 2 enrollment records collapsed into UHC-70426-23
Enrollment records
2
Member id
UHC-70426-23
MBR-015812
Executed
resolution_agent
2026-10-22 12:47:23
4,974 rows, page 48 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.