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-025067
Duplicate member record retired
Member services
Stephanie Mendez: 2 enrollment records collapsed into UHC-15957-27
Enrollment records
2
Member id
UHC-15957-27
MBR-024166
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025068
Duplicate member record retired
Member services
Catherine Riley: 3 enrollment records collapsed into UHC-20404-24
Enrollment records
3
Member id
UHC-20404-24
MBR-024197
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025069
Duplicate member record retired
Member services
Gloria Morgan: 2 enrollment records collapsed into UHC-47653-82
Enrollment records
2
Member id
UHC-47653-82
MBR-024199
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025070
Duplicate member record retired
Member services
Carolyn Lane: 2 enrollment records collapsed into UHC-62433-43
Enrollment records
2
Member id
UHC-62433-43
MBR-024201
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025071
Duplicate member record retired
Member services
Jacqueline Vasquez: 2 enrollment records collapsed into UHC-66201-13
Enrollment records
2
Member id
UHC-66201-13
MBR-024211
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025072
Duplicate member record retired
Member services
Arjun Evans: 2 enrollment records collapsed into UHC-31210-72
Enrollment records
2
Member id
UHC-31210-72
MBR-024230
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025073
Duplicate member record retired
Member services
Albert Schultz: 2 enrollment records collapsed into UHC-79247-71
Enrollment records
2
Member id
UHC-79247-71
MBR-024235
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025074
Duplicate member record retired
Member services
Ahmed Montgomery: 2 enrollment records collapsed into UHC-51952-62
Enrollment records
2
Member id
UHC-51952-62
MBR-024242
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025075
Duplicate member record retired
Member services
Joshua Salazar: 2 enrollment records collapsed into UHC-80367-13
Enrollment records
2
Member id
UHC-80367-13
MBR-024247
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025076
Duplicate member record retired
Member services
Ryan Ruiz: 2 enrollment records collapsed into UHC-53770-84
Enrollment records
2
Member id
UHC-53770-84
MBR-024251
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025077
Duplicate member record retired
Member services
Debra Jimenez: 2 enrollment records collapsed into UHC-59536-77
Enrollment records
2
Member id
UHC-59536-77
MBR-024274
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025078
Duplicate member record retired
Member services
Cynthia Gardner: 2 enrollment records collapsed into UHC-10851-35
Enrollment records
2
Member id
UHC-10851-35
MBR-024305
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025079
Duplicate member record retired
Member services
Samuel Daniels: 3 enrollment records collapsed into UHC-29400-17
Enrollment records
3
Member id
UHC-29400-17
MBR-024313
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025080
Duplicate member record retired
Member services
Jordan Turner: 2 enrollment records collapsed into UHC-81412-09
Enrollment records
2
Member id
UHC-81412-09
MBR-024322
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025081
Duplicate member record retired
Member services
Elizabeth Ray: 2 enrollment records collapsed into UHC-71909-01
Enrollment records
2
Member id
UHC-71909-01
MBR-024335
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025082
Duplicate member record retired
Member services
Betty Butler: 2 enrollment records collapsed into UHC-72899-24
Enrollment records
2
Member id
UHC-72899-24
MBR-024361
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025083
Duplicate member record retired
Member services
Sandra Yang: 2 enrollment records collapsed into UHC-18320-22
Enrollment records
2
Member id
UHC-18320-22
MBR-024373
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025084
Duplicate member record retired
Member services
Hannah Larson: 2 enrollment records collapsed into UHC-78637-88
Enrollment records
2
Member id
UHC-78637-88
MBR-024381
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025085
Duplicate member record retired
Member services
Amanda Walsh: 2 enrollment records collapsed into UHC-09751-10
Enrollment records
2
Member id
UHC-09751-10
MBR-024382
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025086
Duplicate member record retired
Member services
Karen Freeman: 2 enrollment records collapsed into UHC-48570-94
Enrollment records
2
Member id
UHC-48570-94
MBR-024397
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025087
Duplicate member record retired
Member services
Bradley Austin: 2 enrollment records collapsed into UHC-84381-58
Enrollment records
2
Member id
UHC-84381-58
MBR-024409
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025088
Duplicate member record retired
Member services
Sarah Singh: 2 enrollment records collapsed into UHC-56077-44
Enrollment records
2
Member id
UHC-56077-44
MBR-024411
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025089
Duplicate member record retired
Member services
Marc Murray: 2 enrollment records collapsed into UHC-72241-88
Enrollment records
2
Member id
UHC-72241-88
MBR-024414
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025090
Duplicate member record retired
Member services
Paul Henry: 2 enrollment records collapsed into UHC-44952-30
Enrollment records
2
Member id
UHC-44952-30
MBR-024427
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025091
Duplicate member record retired
Member services
Larry Moreno: 2 enrollment records collapsed into UHC-74516-27
Enrollment records
2
Member id
UHC-74516-27
MBR-024433
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025092
Duplicate member record retired
Member services
Gloria Washington: 2 enrollment records collapsed into UHC-72680-37
Enrollment records
2
Member id
UHC-72680-37
MBR-024436
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025093
Duplicate member record retired
Member services
Hiroshi McDonald: 3 enrollment records collapsed into UHC-32228-83
Enrollment records
3
Member id
UHC-32228-83
MBR-024465
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025094
Duplicate member record retired
Member services
Wayne Sanchez: 2 enrollment records collapsed into UHC-45559-54
Enrollment records
2
Member id
UHC-45559-54
MBR-024466
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025095
Duplicate member record retired
Member services
Marc Vargas: 2 enrollment records collapsed into UHC-88195-06
Enrollment records
2
Member id
UHC-88195-06
MBR-024469
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025096
Duplicate member record retired
Member services
Sara Kelley: 2 enrollment records collapsed into UHC-19411-97
Enrollment records
2
Member id
UHC-19411-97
MBR-024498
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025097
Duplicate member record retired
Member services
Priya Reynolds: 2 enrollment records collapsed into UHC-03653-51
Enrollment records
2
Member id
UHC-03653-51
MBR-024501
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025098
Duplicate member record retired
Member services
Richard Johnston: 2 enrollment records collapsed into UHC-01367-54
Enrollment records
2
Member id
UHC-01367-54
MBR-024502
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025099
Duplicate member record retired
Member services
Jacob Cruz: 2 enrollment records collapsed into UHC-04690-02
Enrollment records
2
Member id
UHC-04690-02
MBR-024505
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025100
Duplicate member record retired
Member services
Raymnd Delgado: 2 enrollment records collapsed into UHC-13862-33
Enrollment records
2
Member id
UHC-13862-33
MBR-024507
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025101
Duplicate member record retired
Member services
Jennifer Vezquez: 2 enrollment records collapsed into UHC-17096-95
Enrollment records
2
Member id
UHC-17096-95
MBR-024512
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025102
Duplicate member record retired
Member services
Bryan Guerrero: 3 enrollment records collapsed into UHC-44575-81
Enrollment records
3
Member id
UHC-44575-81
MBR-024525
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025103
Duplicate member record retired
Member services
Thomas Holmes: 2 enrollment records collapsed into UHC-61592-18
Enrollment records
2
Member id
UHC-61592-18
MBR-024546
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025104
Duplicate member record retired
Member services
Marilyn Thompson: 2 enrollment records collapsed into UHC-26376-20
Enrollment records
2
Member id
UHC-26376-20
MBR-024551
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025105
Duplicate member record retired
Member services
Jacob Garcia: 3 enrollment records collapsed into UHC-83504-38
Enrollment records
3
Member id
UHC-83504-38
MBR-024554
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025106
Duplicate member record retired
Member services
Janice Salazar: 2 enrollment records collapsed into UHC-85587-62
Enrollment records
2
Member id
UHC-85587-62
MBR-024555
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025107
Duplicate member record retired
Member services
Mason Gomez: 2 enrollment records collapsed into UHC-14665-92
Enrollment records
2
Member id
UHC-14665-92
MBR-024559
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025108
Duplicate member record retired
Member services
Barbara Espinoza: 2 enrollment records collapsed into UHC-74131-02
Enrollment records
2
Member id
UHC-74131-02
MBR-024565
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025109
Duplicate member record retired
Member services
Aaron Guzman: 3 enrollment records collapsed into UHC-47230-13
Enrollment records
3
Member id
UHC-47230-13
MBR-024569
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025110
Duplicate member record retired
Member services
Ahmed Patel: 2 enrollment records collapsed into UHC-86063-13
Enrollment records
2
Member id
UHC-86063-13
MBR-024580
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025111
Duplicate member record retired
Member services
Eugene Jimenez: 2 enrollment records collapsed into UHC-93297-60
Enrollment records
2
Member id
UHC-93297-60
MBR-024582
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025112
Duplicate member record retired
Member services
Keith Alvarez: 2 enrollment records collapsed into UHC-14541-33
Enrollment records
2
Member id
UHC-14541-33
MBR-024584
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025113
Duplicate member record retired
Member services
Amanda Castillo: 2 enrollment records collapsed into UHC-19670-66
Enrollment records
2
Member id
UHC-19670-66
MBR-024592
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025114
Duplicate member record retired
Member services
Charlotte Matthews: 2 enrollment records collapsed into UHC-91604-76
Enrollment records
2
Member id
UHC-91604-76
MBR-024611
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025115
Duplicate member record retired
Member services
Susan Harper: 2 enrollment records collapsed into UHC-75355-65
Enrollment records
2
Member id
UHC-75355-65
MBR-024619
Executed
resolution_agent
2026-10-22 12:47:23
ACT-025116
Duplicate member record retired
Member services
Terry Cunningham: 3 enrollment records collapsed into UHC-72436-57
Enrollment records
3
Member id
UHC-72436-57
MBR-024630
Executed
resolution_agent
2026-10-22 12:47:23
4,974 rows, page 69 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.