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-008240 | Orphan claim re-pointed Claims processor | CLM-402975 → UHC-39834-94 (Philip Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008241 | Orphan claim re-pointed Claims processor | CLM-423902 → UHC-52881-07 (Maria Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008242 | Orphan claim re-pointed Claims processor | CLM-415221 → UHC-73438-95 (Natahn Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008243 | Orphan claim re-pointed Claims processor | CLM-432349 → UHC-64142-84 (James Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008244 | Orphan claim re-pointed Claims processor | CLM-431357 → UHC-65762-69 (Judith Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008245 | Orphan claim re-pointed Claims processor | CLM-410031 → UHC-67162-01 (Amber Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008246 | Orphan claim re-pointed Claims processor | CLM-408444 → UHC-54400-55 (Stephanie Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008247 | Orphan claim re-pointed Claims processor | CLM-421449 → UHC-47807-89 (Emma Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008248 | Orphan claim re-pointed Claims processor | CLM-418523 → UHC-68813-64 (Evelyn Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008249 | Orphan claim re-pointed Claims processor | CLM-412421 → UHC-44938-15 (Kenneth George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008250 | Orphan claim re-pointed Claims processor | CLM-409973 → UHC-70041-90 (Tyler Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008251 | Orphan claim re-pointed Claims processor | CLM-413461 → UHC-03089-16 (Natalie Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008252 | Orphan claim re-pointed Claims processor | CLM-417170 → UHC-17494-94 (William Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008253 | Orphan claim re-pointed Claims processor | CLM-416706 → UHC-97610-18 (Logan Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008254 | Orphan claim re-pointed Claims processor | CLM-419955 → UHC-51257-13 (Joshua Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008255 | Orphan claim re-pointed Claims processor | CLM-426798 → UHC-60300-25 (Cheryl Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008256 | Orphan claim re-pointed Claims processor | CLM-428994 → UHC-35249-07 (Jack Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008257 | Orphan claim re-pointed Claims processor | CLM-406472 → UHC-34621-51 (Lauren Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008258 | Orphan claim re-pointed Claims processor | CLM-405524 → UHC-69609-12 (Nathan Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008259 | Orphan claim re-pointed Claims processor | CLM-415915 → UHC-27625-41 (Julie Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008260 | Orphan claim re-pointed Claims processor | CLM-406332 → UHC-44493-32 (Betty Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008261 | Orphan claim re-pointed Claims processor | CLM-426303 → UHC-31983-88 (Gloria Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008262 | Orphan claim re-pointed Claims processor | CLM-408641 → UHC-99435-72 (Cole Amanda) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008263 | Orphan claim re-pointed Claims processor | CLM-410448 → UHC-64090-94 (Diane Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008264 | Orphan claim re-pointed Claims processor | CLM-400309 → UHC-57287-39 (Martha Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008265 | Orphan claim re-pointed Claims processor | CLM-407290 → UHC-10875-81 (Lisa Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008266 | Orphan claim re-pointed Claims processor | CLM-417791 → UHC-26672-93 (Fatima Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008267 | Orphan claim re-pointed Claims processor | CLM-414417 → UHC-21726-19 (Ronald Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008268 | Orphan claim re-pointed Claims processor | CLM-424647 → UHC-71648-50 (Donna Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008269 | Orphan claim re-pointed Claims processor | CLM-431675 → UHC-74205-24 (Sophia Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008270 | Orphan claim re-pointed Claims processor | CLM-432072 → UHC-98891-36 (Helen Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008271 | Orphan claim re-pointed Claims processor | CLM-425918 → UHC-24880-90 (Lisa Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008272 | Orphan claim re-pointed Claims processor | CLM-410821 → UHC-94742-18 (Teresa Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008273 | Orphan claim re-pointed Claims processor | CLM-408557 → UHC-06060-75 (Jerry Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008274 | Orphan claim re-pointed Claims processor | CLM-414962 → UHC-56461-21 (Lucia Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008275 | Orphan claim re-pointed Claims processor | CLM-403985 → UHC-34189-13 (Ahmed Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008276 | Orphan claim re-pointed Claims processor | CLM-422310 → UHC-34991-32 (Omar Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008277 | Orphan claim re-pointed Claims processor | CLM-403250 → UHC-62413-34 (Carlos Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008278 | Orphan claim re-pointed Claims processor | CLM-401926 → UHC-44692-67 (Daniel Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008279 | Orphan claim re-pointed Claims processor | CLM-407545 → UHC-08444-39 (Juan Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008280 | Orphan claim re-pointed Claims processor | CLM-400783 → UHC-70675-02 (Fatima Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008281 | Orphan claim re-pointed Claims processor | CLM-410989 → UHC-49315-22 (Gerald Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008282 | Orphan claim re-pointed Claims processor | CLM-400474 → UHC-74466-79 (John Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008283 | Orphan claim re-pointed Claims processor | CLM-401429 → UHC-39816-02 (Brian Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008284 | Orphan claim re-pointed Claims processor | CLM-415140 → UHC-79306-09 (Doulas Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008285 | Orphan claim re-pointed Claims processor | CLM-423597 → UHC-16289-79 (Wayne Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008286 | Orphan claim re-pointed Claims processor | CLM-426143 → UHC-12128-03 (Christian Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008287 | Orphan claim re-pointed Claims processor | CLM-415888 → UHC-85719-06 (Alan Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008288 | Orphan claim re-pointed Claims processor | CLM-414890 → UHC-48337-47 (David Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008289 | Orphan claim re-pointed Claims processor | CLM-401880 → UHC-51254-08 (Patricia Wood) |
| 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.