About Merging Suspect Duplicates

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About Merging Suspect Duplicates

Occasionally, there may be duplicate members in ND MMIS. For example, Rob Smith and Robert Smith with similar dates of birth or other factors might be identified as suspect duplicate members. Member Specialist are required to research and identify suspect duplicate members before performing any maintenance functions such as merging, unmerging, or transferring claims between those believed to be duplicates. See How to Identify Suspect Duplicates for additional information.

<<What will be necessary in Enterprise if the duplicates are merged in ND's eligibility system? Is there some kind of batch process that will trigger the same to be done in Enterprise?>>

Duplicates Are Different People

If the suspect duplicates are really two different people the suspected duplicate ID information needs to be deleted on the Member Details Maintenance page so that ND MMIS does not identify them as suspects again.

If information and claims have been combined in an incorrect ID, then they must be separated - unmerged. See What Is Unmerge Alternate ID Transfer? for additional information on this process.

Duplicates Are the Same Person

If the suspect duplicates are the same person, then you can choose to merge the duplicates either online or in batch.

Tip: You can only choose one of the suspect duplicate IDs to merge with the target at one time. If there are multiple IDs that need to be merged, you must make a note of the internal system IDs of the other sources to merge later.

Choosing to merge online may lock system resources for a period of time while the updates are made. Because of this, you may want to choose the batch option. <<Is this a valid statement? And even if it is, should we make it?>>>

The following records are added to the target member and then deleted from the source:

Category of Eligibility (COE) spans
Benefit plan enrollment spans
Primary care physician spans
Review spans
Medicare spans
Long term care spans
Buy-in transactions
Third-party liability transactions
Service authorizations
Member representative spans
Recipient Liability/Responsibility spans
Other information, except demographic information (which is not merged)
Claims, creating a mass adjustment request for each claim to be transferred which must be reviewed and released for processing <<Is this a true statement about this request? Is there a special Merge view for the Claims Transfer page? I don't see it in your design doc for Transfer is why I'm confused about the process.>>>>
Alternate IDs
Member ID card, requesting a new card for the target member and deactivating the card for the source

Instructions

How to Identify Suspect Duplicates

How to Merge Suspect Duplicates

How to Maintain Suspect Duplicates

Field Descriptions

Merge Suspect Duplicate Members Page