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
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-001940 | Orphan claim re-pointed Claims processor | CLM-403316 → UHC-33275-94 (Scott Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001941 | Orphan claim re-pointed Claims processor | CLM-424825 → UHC-99586-03 (Dennis Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001942 | Orphan claim re-pointed Claims processor | CLM-406473 → UHC-44301-74 (Laura Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001943 | Orphan claim re-pointed Claims processor | CLM-421727 → UHC-88787-58 (Mason Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001944 | Orphan claim re-pointed Claims processor | CLM-412984 → UHC-09672-15 (Katherine Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001945 | Orphan claim re-pointed Claims processor | CLM-427208 → UHC-79652-17 (Julei Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001946 | Orphan claim re-pointed Claims processor | CLM-427555 → UHC-47559-10 (Kimberly Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001947 | Orphan claim re-pointed Claims processor | CLM-414755 → UHC-87599-06 (Sandra Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001948 | Orphan claim re-pointed Claims processor | CLM-406282 → UHC-30938-27 (Eric Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001949 | Orphan claim re-pointed Claims processor | CLM-411096 → UHC-39290-82 (Brittany Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001950 | Orphan claim re-pointed Claims processor | CLM-409163 → UHC-16666-12 (Nicole Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001951 | Orphan claim re-pointed Claims processor | CLM-410705 → UHC-58876-62 (Jacob Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001952 | Orphan claim re-pointed Claims processor | CLM-428457 → UHC-75478-15 (Judith Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001953 | Orphan claim re-pointed Claims processor | CLM-420147 → UHC-21009-42 (Susan Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001954 | Orphan claim re-pointed Claims processor | CLM-432402 → UHC-35606-34 (Peter Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001955 | Orphan claim re-pointed Claims processor | CLM-418870 → UHC-43519-95 (Kathryn Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001956 | Orphan claim re-pointed Claims processor | CLM-430446 → UHC-97803-20 (Mariana Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001957 | Orphan claim re-pointed Claims processor | CLM-408775 → UHC-29986-91 (Gary Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001958 | Orphan claim re-pointed Claims processor | CLM-427701 → UHC-33223-95 (Katherine West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001959 | Orphan claim re-pointed Claims processor | CLM-428353 → UHC-58395-71 (Keith Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001960 | Orphan claim re-pointed Claims processor | CLM-432168 → UHC-83355-82 (Logan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001961 | Orphan claim re-pointed Claims processor | CLM-400855 → UHC-59014-76 (Carol Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001962 | Orphan claim re-pointed Claims processor | CLM-404475 → UHC-81889-78 (Billy Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001963 | Orphan claim re-pointed Claims processor | CLM-419618 → UHC-34568-51 (Aaron Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001964 | Orphan claim re-pointed Claims processor | CLM-406616 → UHC-14987-56 (Denise Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001965 | Orphan claim re-pointed Claims processor | CLM-407999 → UHC-72810-50 (Jean Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001966 | Orphan claim re-pointed Claims processor | CLM-405300 → UHC-47191-35 (Austin Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001967 | Orphan claim re-pointed Claims processor | CLM-424148 → UHC-12380-01 (Angela Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001968 | Orphan claim re-pointed Claims processor | CLM-410133 → UHC-11547-97 (Andrew Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001969 | Orphan claim re-pointed Claims processor | CLM-417074 → UHC-24476-29 (Hannah Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001970 | Orphan claim re-pointed Claims processor | CLM-426682 → UHC-46251-99 (Judith Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001971 | Orphan claim re-pointed Claims processor | CLM-415321 → UHC-06505-43 (Wayne Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001972 | Orphan claim re-pointed Claims processor | CLM-410299 → UHC-33350-17 (Bruce Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001973 | Orphan claim re-pointed Claims processor | CLM-412516 → UHC-63950-13 (Edward Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001974 | Orphan claim re-pointed Claims processor | CLM-415250 → UHC-20079-30 (Tyler Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001975 | Orphan claim re-pointed Claims processor | CLM-429859 → UHC-19864-11 (Noah Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001976 | Orphan claim re-pointed Claims processor | CLM-406518 → UHC-44206-31 (Sarah Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001977 | Orphan claim re-pointed Claims processor | CLM-422405 → UHC-80915-35 (Mei Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001978 | Orphan claim re-pointed Claims processor | CLM-410608 → UHC-60515-86 (Mei Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001979 | Orphan claim re-pointed Claims processor | CLM-423976 → UHC-94658-36 (Luis Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001980 | Orphan claim re-pointed Claims processor | CLM-421222 → UHC-45946-22 (Christian Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001981 | Orphan claim re-pointed Claims processor | CLM-431123 → UHC-06582-86 (Jacob Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001982 | Orphan claim re-pointed Claims processor | CLM-431749 → UHC-00957-09 (Mari Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001983 | Orphan claim re-pointed Claims processor | CLM-428193 → UHC-40906-06 (Noah Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001984 | Orphan claim re-pointed Claims processor | CLM-423692 → UHC-53868-27 (Deborah Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001985 | Orphan claim re-pointed Claims processor | CLM-420938 → UHC-74540-84 (Judith Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001986 | Orphan claim re-pointed Claims processor | CLM-432326 → UHC-53497-10 (Walter Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001987 | Orphan claim re-pointed Claims processor | CLM-408454 → UHC-03826-60 (Margaret Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001988 | Orphan claim re-pointed Claims processor | CLM-405593 → UHC-23703-76 (Catherine Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001989 | Orphan claim re-pointed Claims processor | CLM-421711 → UHC-84006-39 (Laura Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 |
Derivation rules
Evaluated after every gold rebuild
- 1Eligibility conflict resolvedThe records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
- 2Orphan claim re-pointedA 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.
- 3Outreach address correctedThe most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
- 4Outreach suppressed pending stewardThe record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
- 5Care coordination outreachThree or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
- 6New member onboardingA single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
- 7Duplicate member record retiredTwo or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.