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-004540 | Orphan claim re-pointed Claims processor | CLM-430525 → UHC-78713-50 (Grace Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004541 | Orphan claim re-pointed Claims processor | CLM-428306 → UHC-63351-43 (Jerry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004542 | Orphan claim re-pointed Claims processor | CLM-414191 → UHC-98991-98 (Ambber Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004543 | Orphan claim re-pointed Claims processor | CLM-429814 → UHC-06078-43 (Joseph Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004544 | Orphan claim re-pointed Claims processor | CLM-420364 → UHC-23204-76 (Ashley Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004545 | Orphan claim re-pointed Claims processor | CLM-411453 → UHC-61918-98 (Ethan Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004546 | Orphan claim re-pointed Claims processor | CLM-419767 → UHC-95770-57 (Chris Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004547 | Orphan claim re-pointed Claims processor | CLM-410574 → UHC-91658-38 (Margaret Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004548 | Orphan claim re-pointed Claims processor | CLM-429447 → UHC-39801-46 (Richard Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004549 | Orphan claim re-pointed Claims processor | CLM-404799 → UHC-68046-13 (Jason Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004550 | Orphan claim re-pointed Claims processor | CLM-417555 → UHC-25544-03 (Billy Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004551 | Orphan claim re-pointed Claims processor | CLM-422953 → UHC-74442-37 (Nancy Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004552 | Orphan claim re-pointed Claims processor | CLM-423492 → UHC-59530-27 (Gabriel Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004553 | Orphan claim re-pointed Claims processor | CLM-424732 → UHC-17116-81 (Joseph Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004554 | Orphan claim re-pointed Claims processor | CLM-416628 → UHC-44112-92 (Gonzales Diana) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004555 | Orphan claim re-pointed Claims processor | CLM-419346 → UHC-62694-54 (Carlos Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004556 | Orphan claim re-pointed Claims processor | CLM-415472 → UHC-71500-43 (James Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004557 | Orphan claim re-pointed Claims processor | CLM-431787 → UHC-67143-84 (Philip Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004558 | Orphan claim re-pointed Claims processor | CLM-427083 → UHC-17770-72 (Anna Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004559 | Orphan claim re-pointed Claims processor | CLM-402107 → UHC-60711-64 (Charlotte Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004560 | Orphan claim re-pointed Claims processor | CLM-420325 → UHC-93718-40 (Lawrence Nichhols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004561 | Orphan claim re-pointed Claims processor | CLM-423688 → UHC-30422-67 (Aaron Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004562 | Orphan claim re-pointed Claims processor | CLM-410906 → UHC-73708-61 (Laura Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004563 | Orphan claim re-pointed Claims processor | CLM-422761 → UHC-40438-30 (Paul King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004564 | Orphan claim re-pointed Claims processor | CLM-412318 → UHC-80658-32 (John Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004565 | Orphan claim re-pointed Claims processor | CLM-419485 → UHC-27593-40 (Gerald Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004566 | Orphan claim re-pointed Claims processor | CLM-402811 → UHC-52239-76 (Brandon Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004567 | Orphan claim re-pointed Claims processor | CLM-400709 → UHC-35819-35 (Jacob Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004568 | Orphan claim re-pointed Claims processor | CLM-406227 → UHC-83109-91 (Nicholas Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004569 | Orphan claim re-pointed Claims processor | CLM-415074 → UHC-31919-96 (Sarah Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004570 | Orphan claim re-pointed Claims processor | CLM-412293 → UHC-18381-60 (Matthew Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004571 | Orphan claim re-pointed Claims processor | CLM-406929 → UHC-06351-52 (Sanitago Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004572 | Orphan claim re-pointed Claims processor | CLM-403242 → UHC-21738-50 (Keith Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004573 | Orphan claim re-pointed Claims processor | CLM-425766 → UHC-00616-73 (Anthony Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004574 | Orphan claim re-pointed Claims processor | CLM-430807 → UHC-35070-76 (Ryan Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004575 | Orphan claim re-pointed Claims processor | CLM-415009 → UHC-06230-57 (Sofia Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004576 | Orphan claim re-pointed Claims processor | CLM-401351 → UHC-13237-39 (Carolyn Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004577 | Orphan claim re-pointed Claims processor | CLM-425726 → UHC-06763-58 (Matthew Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004578 | Orphan claim re-pointed Claims processor | CLM-410847 → UHC-08618-64 (Carolyn Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004579 | Orphan claim re-pointed Claims processor | CLM-425018 → UHC-70793-11 (Alan Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004580 | Orphan claim re-pointed Claims processor | CLM-427363 → UHC-85220-86 (Peter Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004581 | Orphan claim re-pointed Claims processor | CLM-401585 → UHC-95759-83 (Wayne Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004582 | Orphan claim re-pointed Claims processor | CLM-424255 → UHC-38641-40 (Scott Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004583 | Orphan claim re-pointed Claims processor | CLM-428010 → UHC-52094-05 (Michael Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004584 | Orphan claim re-pointed Claims processor | CLM-412098 → UHC-38723-32 (Abigail Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004585 | Orphan claim re-pointed Claims processor | CLM-404580 → UHC-65469-13 (Melissa Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004586 | Orphan claim re-pointed Claims processor | CLM-407399 → UHC-37090-99 (Pamela Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004587 | Orphan claim re-pointed Claims processor | CLM-402768 → UHC-82117-14 (Gloria Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004588 | Orphan claim re-pointed Claims processor | CLM-415600 → UHC-70821-83 (Aisha Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004589 | Orphan claim re-pointed Claims processor | CLM-432768 → UHC-11191-55 (Margaret Hall) |
| 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.