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-005390 | Orphan claim re-pointed Claims processor | CLM-400663 → UHC-21000-52 (Nicole Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005391 | Orphan claim re-pointed Claims processor | CLM-405265 → UHC-90372-35 (Eugene Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005392 | Orphan claim re-pointed Claims processor | CLM-410021 → UHC-88472-34 (Jose Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005393 | Orphan claim re-pointed Claims processor | CLM-423511 → UHC-19511-99 (Raymond Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005394 | Orphan claim re-pointed Claims processor | CLM-403573 → UHC-48277-68 (Sandra Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005395 | Orphan claim re-pointed Claims processor | CLM-430969 → UHC-86487-27 (Sharon Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005396 | Orphan claim re-pointed Claims processor | CLM-410962 → UHC-72665-54 (Martha Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005397 | Orphan claim re-pointed Claims processor | CLM-407199 → UHC-82425-52 (Henry Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005398 | Orphan claim re-pointed Claims processor | CLM-418845 → UHC-84212-31 (David Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005399 | Orphan claim re-pointed Claims processor | CLM-426392 → UHC-82755-81 (Teresa Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005400 | Orphan claim re-pointed Claims processor | CLM-403114 → UHC-58119-10 (George Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005401 | Orphan claim re-pointed Claims processor | CLM-419209 → UHC-96845-24 (Judith Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005402 | Orphan claim re-pointed Claims processor | CLM-422002 → UHC-25901-27 (Sara Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005403 | Orphan claim re-pointed Claims processor | CLM-406560 → UHC-88200-21 (Ashley Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005404 | Orphan claim re-pointed Claims processor | CLM-400483 → UHC-37270-06 (Hiroshi Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005405 | Orphan claim re-pointed Claims processor | CLM-404436 → UHC-46549-70 (Charlotte Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005406 | Orphan claim re-pointed Claims processor | CLM-403491 → UHC-91422-70 (Martha Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005407 | Orphan claim re-pointed Claims processor | CLM-429556 → UHC-17159-14 (Alexis Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005408 | Orphan claim re-pointed Claims processor | CLM-413981 → UHC-05998-73 (Kayla Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005409 | Orphan claim re-pointed Claims processor | CLM-406440 → UHC-52357-03 (Angela King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005410 | Orphan claim re-pointed Claims processor | CLM-417503 → UHC-24535-03 (Carolyn Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005411 | Orphan claim re-pointed Claims processor | CLM-426411 → UHC-53313-88 (Frances Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005412 | Orphan claim re-pointed Claims processor | CLM-423821 → UHC-41207-82 (Nicholas Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005413 | Orphan claim re-pointed Claims processor | CLM-404197 → UHC-24344-88 (Camila McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005414 | Orphan claim re-pointed Claims processor | CLM-427118 → UHC-48725-02 (Gabriel Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005415 | Orphan claim re-pointed Claims processor | CLM-423490 → UHC-65270-97 (Ralph Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005416 | Orphan claim re-pointed Claims processor | CLM-400992 → UHC-79174-43 (Amber Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005417 | Orphan claim re-pointed Claims processor | CLM-419392 → UHC-44979-65 (James Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005418 | Orphan claim re-pointed Claims processor | CLM-426436 → UHC-60488-61 (Jennfier Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005419 | Orphan claim re-pointed Claims processor | CLM-409220 → UHC-90036-38 (Heather Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005420 | Orphan claim re-pointed Claims processor | CLM-403722 → UHC-60087-69 (Julie Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005421 | Orphan claim re-pointed Claims processor | CLM-415970 → UHC-67865-24 (Jennifer Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005422 | Orphan claim re-pointed Claims processor | CLM-409714 → UHC-41766-43 (Patrick Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005423 | Orphan claim re-pointed Claims processor | CLM-430166 → UHC-13037-47 (Joseph Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005424 | Orphan claim re-pointed Claims processor | CLM-420201 → UHC-20155-43 (Mateo Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005425 | Orphan claim re-pointed Claims processor | CLM-408478 → UHC-22806-16 (Donald Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005426 | Orphan claim re-pointed Claims processor | CLM-424147 → UHC-81936-57 (Michael Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005427 | Orphan claim re-pointed Claims processor | CLM-425847 → UHC-87750-98 (Carl Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005428 | Orphan claim re-pointed Claims processor | CLM-403507 → UHC-84546-46 (Ruth Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005429 | Orphan claim re-pointed Claims processor | CLM-420807 → UHC-57654-16 (Jordan Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005430 | Orphan claim re-pointed Claims processor | CLM-429407 → UHC-79908-24 (Edward Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005431 | Orphan claim re-pointed Claims processor | CLM-423262 → UHC-89345-39 (Donna Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005432 | Orphan claim re-pointed Claims processor | CLM-418589 → UHC-59588-89 (Arjun Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005433 | Orphan claim re-pointed Claims processor | CLM-424676 → UHC-09319-18 (Jerry Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005434 | Orphan claim re-pointed Claims processor | CLM-406471 → UHC-34621-51 (Lauren Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005435 | Orphan claim re-pointed Claims processor | CLM-409027 → UHC-97382-48 (Aaron Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005436 | Orphan claim re-pointed Claims processor | CLM-423459 → UHC-60980-69 (Kevin Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005437 | Orphan claim re-pointed Claims processor | CLM-406735 → UHC-53310-24 (Christian Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005438 | Orphan claim re-pointed Claims processor | CLM-413287 → UHC-79029-76 (Tyler Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005439 | Orphan claim re-pointed Claims processor | CLM-419303 → UHC-43606-64 (Shirley Gibson) |
| 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.