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-004940 | Orphan claim re-pointed Claims processor | CLM-410679 → UHC-70285-55 (Bobby Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004941 | Orphan claim re-pointed Claims processor | CLM-419486 → UHC-05981-64 (Raymond Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004942 | Orphan claim re-pointed Claims processor | CLM-409625 → UHC-38082-71 (Ann Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004943 | Orphan claim re-pointed Claims processor | CLM-409123 → UHC-77399-76 (Logan Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004944 | Orphan claim re-pointed Claims processor | CLM-428768 → UHC-21688-31 (Kyle Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004945 | Orphan claim re-pointed Claims processor | CLM-413104 → UHC-02443-02 (Lori Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004946 | Orphan claim re-pointed Claims processor | CLM-407465 → UHC-39735-08 (Barbara Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004947 | Orphan claim re-pointed Claims processor | CLM-417155 → UHC-31823-84 (Rachel Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004948 | Orphan claim re-pointed Claims processor | CLM-427104 → UHC-84726-80 (Lori Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004949 | Orphan claim re-pointed Claims processor | CLM-426177 → UHC-22708-92 (Jose Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004950 | Orphan claim re-pointed Claims processor | CLM-408613 → UHC-65445-38 (Matthew Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004951 | Orphan claim re-pointed Claims processor | CLM-425952 → UHC-93558-25 (Jennier Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004952 | Orphan claim re-pointed Claims processor | CLM-424800 → UHC-11375-71 (Keith Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004953 | Orphan claim re-pointed Claims processor | CLM-411548 → UHC-94243-99 (Martha Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004954 | Orphan claim re-pointed Claims processor | CLM-406216 → UHC-20565-29 (Lauren Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004955 | Orphan claim re-pointed Claims processor | CLM-408032 → UHC-18542-99 (Deborah Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004956 | Orphan claim re-pointed Claims processor | CLM-418572 → UHC-21529-84 (Danielle Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004957 | Orphan claim re-pointed Claims processor | CLM-413887 → UHC-89891-19 (Carol Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004958 | Orphan claim re-pointed Claims processor | CLM-400466 → UHC-08752-97 (Wayne Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004959 | Orphan claim re-pointed Claims processor | CLM-431290 → UHC-61154-15 (Roy Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004960 | Orphan claim re-pointed Claims processor | CLM-401059 → UHC-17944-90 (Charles Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004961 | Orphan claim re-pointed Claims processor | CLM-403395 → UHC-66248-58 (Ahmed Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004962 | Orphan claim re-pointed Claims processor | CLM-426348 → UHC-40687-94 (Aaron Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004963 | Orphan claim re-pointed Claims processor | CLM-416422 → UHC-13274-63 (Roger Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004964 | Orphan claim re-pointed Claims processor | CLM-414376 → UHC-68756-92 (Amber Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004965 | Orphan claim re-pointed Claims processor | CLM-403418 → UHC-44424-97 (Bruce Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004966 | Orphan claim re-pointed Claims processor | CLM-403627 → UHC-26683-20 (Edward Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004967 | Orphan claim re-pointed Claims processor | CLM-427007 → UHC-49778-06 (Adam Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004968 | Orphan claim re-pointed Claims processor | CLM-414739 → UHC-52659-90 (Sandra Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004969 | Orphan claim re-pointed Claims processor | CLM-430718 → UHC-02982-66 (Amanda Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004970 | Orphan claim re-pointed Claims processor | CLM-410029 → UHC-19618-72 (William Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004971 | Orphan claim re-pointed Claims processor | CLM-407150 → UHC-38319-19 (Hannah Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004972 | Orphan claim re-pointed Claims processor | CLM-422300 → UHC-28465-51 (Kimberly Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004973 | Orphan claim re-pointed Claims processor | CLM-410336 → UHC-09689-71 (Jake Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004974 | Orphan claim re-pointed Claims processor | CLM-429583 → UHC-47902-51 (Victoria Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004975 | Orphan claim re-pointed Claims processor | CLM-407846 → UHC-60044-90 (Bobby Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004976 | Orphan claim re-pointed Claims processor | CLM-424743 → UHC-06546-55 (Christine Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004977 | Orphan claim re-pointed Claims processor | CLM-425677 → UHC-15231-85 (Bryan Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004978 | Orphan claim re-pointed Claims processor | CLM-417373 → UHC-72664-23 (Jessica Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004979 | Orphan claim re-pointed Claims processor | CLM-409782 → UHC-36165-09 (Mei Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004980 | Orphan claim re-pointed Claims processor | CLM-428216 → UHC-26416-03 (Rebecca Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004981 | Orphan claim re-pointed Claims processor | CLM-432495 → UHC-20991-85 (Cheryl Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004982 | Orphan claim re-pointed Claims processor | CLM-430419 → UHC-29993-99 (Diane Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004983 | Orphan claim re-pointed Claims processor | CLM-407781 → UHC-71023-24 (William Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004984 | Orphan claim re-pointed Claims processor | CLM-419679 → UHC-16262-32 (Abigail Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004985 | Orphan claim re-pointed Claims processor | CLM-402520 → UHC-20227-50 (Douglas Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004986 | Orphan claim re-pointed Claims processor | CLM-411236 → UHC-24705-10 (Billy Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004987 | Orphan claim re-pointed Claims processor | CLM-404854 → UHC-35998-11 (Carolyn Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004988 | Orphan claim re-pointed Claims processor | CLM-410044 → UHC-92857-60 (Sean Sean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004989 | Orphan claim re-pointed Claims processor | CLM-424008 → UHC-55114-04 (Brenda Patterson) |
| 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.