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-008440 | Orphan claim re-pointed Claims processor | CLM-432145 → UHC-52291-89 (Donna Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008441 | Orphan claim re-pointed Claims processor | CLM-427745 → UHC-59222-88 (Wayne Colman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008442 | Orphan claim re-pointed Claims processor | CLM-401008 → UHC-76027-12 (Jesse Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008443 | Orphan claim re-pointed Claims processor | CLM-430246 → UHC-61619-78 (Brenda Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008444 | Orphan claim re-pointed Claims processor | CLM-409170 → UHC-89679-38 (Sophia Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008445 | Orphan claim re-pointed Claims processor | CLM-429692 → UHC-70178-05 (Ashley Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008446 | Orphan claim re-pointed Claims processor | CLM-411252 → UHC-50303-16 (Nancy Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008447 | Orphan claim re-pointed Claims processor | CLM-423331 → UHC-27643-08 (Paul Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008448 | Orphan claim re-pointed Claims processor | CLM-420365 → UHC-94337-87 (Cynthia Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008449 | Orphan claim re-pointed Claims processor | CLM-429569 → UHC-54608-62 (Christopher Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008450 | Orphan claim re-pointed Claims processor | CLM-403776 → UHC-85597-57 (Nicole Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008451 | Orphan claim re-pointed Claims processor | CLM-409689 → UHC-57574-35 (Megan West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008452 | Orphan claim re-pointed Claims processor | CLM-412496 → UHC-23934-72 (Steven Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008453 | Orphan claim re-pointed Claims processor | CLM-408734 → UHC-49250-28 (Yuki Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008454 | Orphan claim re-pointed Claims processor | CLM-414580 → UHC-32429-71 (Kayla Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008455 | Orphan claim re-pointed Claims processor | CLM-405371 → UHC-82998-58 (Danielle Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008456 | Orphan claim re-pointed Claims processor | CLM-415543 → UHC-61925-07 (Eugene Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008457 | Orphan claim re-pointed Claims processor | CLM-409360 → UHC-34135-53 (Susan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008458 | Orphan claim re-pointed Claims processor | CLM-408133 → UHC-21993-89 (Andrea Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008459 | Orphan claim re-pointed Claims processor | CLM-420845 → UHC-03014-10 (Gary Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008460 | Orphan claim re-pointed Claims processor | CLM-432149 → UHC-69545-33 (Benjamin Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008461 | Orphan claim re-pointed Claims processor | CLM-427746 → UHC-55520-85 (Mark Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008462 | Orphan claim re-pointed Claims processor | CLM-413624 → UHC-21997-61 (Eric Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008463 | Orphan claim re-pointed Claims processor | CLM-428243 → UHC-44389-59 (Jacqueline West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008464 | Orphan claim re-pointed Claims processor | CLM-430475 → UHC-58815-25 (Vincent Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008465 | Orphan claim re-pointed Claims processor | CLM-412839 → UHC-15044-36 (Ryan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008466 | Orphan claim re-pointed Claims processor | CLM-402982 → UHC-22125-14 (Kevin Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008467 | Orphan claim re-pointed Claims processor | CLM-418650 → UHC-92169-35 (Billy Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008468 | Orphan claim re-pointed Claims processor | CLM-416303 → UHC-44423-90 (Philip Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008469 | Orphan claim re-pointed Claims processor | CLM-428665 → UHC-30839-28 (Beverly Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008470 | Orphan claim re-pointed Claims processor | CLM-402659 → UHC-35142-11 (Nathan McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008471 | Orphan claim re-pointed Claims processor | CLM-423430 → UHC-26304-24 (Ralph Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008472 | Orphan claim re-pointed Claims processor | CLM-429734 → UHC-57646-71 (Ralph Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008473 | Orphan claim re-pointed Claims processor | CLM-412012 → UHC-53248-15 (Santiago Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008474 | Orphan claim re-pointed Claims processor | CLM-400063 → UHC-95544-56 (Christian Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008475 | Orphan claim re-pointed Claims processor | CLM-404744 → UHC-57000-99 (Alexander Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008476 | Orphan claim re-pointed Claims processor | CLM-424773 → UHC-03381-49 (Andrea Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008477 | Orphan claim re-pointed Claims processor | CLM-424445 → UHC-64561-81 (Charles Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008478 | Orphan claim re-pointed Claims processor | CLM-409783 → UHC-29887-60 (Grace Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008479 | Orphan claim re-pointed Claims processor | CLM-406017 → UHC-32609-65 (Deborah Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008480 | Orphan claim re-pointed Claims processor | CLM-407346 → UHC-31271-01 (Therasa Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008481 | Orphan claim re-pointed Claims processor | CLM-429883 → UHC-68447-74 (Valentina Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008482 | Orphan claim re-pointed Claims processor | CLM-419336 → UHC-38763-55 (Janice Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008483 | Orphan claim re-pointed Claims processor | CLM-424282 → UHC-99478-30 (Katherine Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008484 | Orphan claim re-pointed Claims processor | CLM-425443 → UHC-88416-78 (Maria Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008485 | Orphan claim re-pointed Claims processor | CLM-428127 → UHC-29043-03 (Roy Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008486 | Orphan claim re-pointed Claims processor | CLM-414911 → UHC-89766-39 (Dennis Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008487 | Orphan claim re-pointed Claims processor | CLM-421534 → UHC-20670-78 (Kelly Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008488 | Orphan claim re-pointed Claims processor | CLM-403933 → UHC-80073-60 (Logan Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008489 | Orphan claim re-pointed Claims processor | CLM-421493 → UHC-99018-57 (Billy Welch) |
| 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.