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-005640 | Orphan claim re-pointed Claims processor | CLM-403306 → UHC-59675-28 (Hannah Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005641 | Orphan claim re-pointed Claims processor | CLM-422158 → UHC-77209-51 (Steven Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005642 | Orphan claim re-pointed Claims processor | CLM-422254 → UHC-83369-97 (Bobby Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005643 | Orphan claim re-pointed Claims processor | CLM-431100 → UHC-46389-21 (Kimberly Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005644 | Orphan claim re-pointed Claims processor | CLM-404335 → UHC-24935-31 (Daniel Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005645 | Orphan claim re-pointed Claims processor | CLM-414401 → UHC-25825-42 (Danielle Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005646 | Orphan claim re-pointed Claims processor | CLM-431198 → UHC-14479-29 (Wayne Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005647 | Orphan claim re-pointed Claims processor | CLM-432665 → UHC-52129-98 (Zachary Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005648 | Orphan claim re-pointed Claims processor | CLM-428459 → UHC-50518-63 (Martha Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005649 | Orphan claim re-pointed Claims processor | CLM-400113 → UHC-87640-10 (Joseph Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005650 | Orphan claim re-pointed Claims processor | CLM-401614 → UHC-37758-70 (Ralph Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005651 | Orphan claim re-pointed Claims processor | CLM-411217 → UHC-90335-73 (Victoria Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005652 | Orphan claim re-pointed Claims processor | CLM-423156 → UHC-06309-97 (Natalie Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005653 | Orphan claim re-pointed Claims processor | CLM-416862 → UHC-21154-82 (David Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005654 | Orphan claim re-pointed Claims processor | CLM-405766 → UHC-63658-24 (Ralph Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005655 | Orphan claim re-pointed Claims processor | CLM-408782 → UHC-11581-57 (Russell Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005656 | Orphan claim re-pointed Claims processor | CLM-430794 → UHC-87523-64 (Brittany Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005657 | Orphan claim re-pointed Claims processor | CLM-402373 → UHC-24160-93 (Matthew Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005658 | Orphan claim re-pointed Claims processor | CLM-400345 → UHC-94513-70 (Eugene Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005659 | Orphan claim re-pointed Claims processor | CLM-410343 → UHC-31741-46 (Megan Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005660 | Orphan claim re-pointed Claims processor | CLM-430567 → UHC-53365-30 (Diane Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005661 | Orphan claim re-pointed Claims processor | CLM-430048 → UHC-24100-19 (Martha Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005662 | Orphan claim re-pointed Claims processor | CLM-406545 → UHC-97825-92 (Brian Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005663 | Orphan claim re-pointed Claims processor | CLM-418291 → UHC-49860-99 (Margaret Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005664 | Orphan claim re-pointed Claims processor | CLM-406610 → UHC-64413-52 (Sophia Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005665 | Orphan claim re-pointed Claims processor | CLM-401691 → UHC-65220-77 (Daniel Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005666 | Orphan claim re-pointed Claims processor | CLM-430285 → UHC-25449-95 (Deborah Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005667 | Orphan claim re-pointed Claims processor | CLM-411738 → UHC-25309-64 (Janet Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005668 | Orphan claim re-pointed Claims processor | CLM-419071 → UHC-35369-94 (Timothy Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005669 | Orphan claim re-pointed Claims processor | CLM-417726 → UHC-36471-89 (Logan Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005670 | Orphan claim re-pointed Claims processor | CLM-423475 → UHC-10004-82 (Walter Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005671 | Orphan claim re-pointed Claims processor | CLM-407578 → UHC-91479-96 (Steven McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005672 | Orphan claim re-pointed Claims processor | CLM-417201 → UHC-33529-32 (Marilyn Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005673 | Orphan claim re-pointed Claims processor | CLM-430521 → UHC-49979-38 (Ronald Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005674 | Orphan claim re-pointed Claims processor | CLM-423153 → UHC-66125-48 (Matthew Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005675 | Orphan claim re-pointed Claims processor | CLM-402823 → UHC-59591-67 (Kimberly Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005676 | Orphan claim re-pointed Claims processor | CLM-415503 → UHC-79204-52 (Ryan Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005677 | Orphan claim re-pointed Claims processor | CLM-430732 → UHC-04129-68 (Sharon Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005678 | Orphan claim re-pointed Claims processor | CLM-402647 → UHC-95138-15 (Wayne McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005679 | Orphan claim re-pointed Claims processor | CLM-417072 → UHC-77656-36 (Dennis Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005680 | Orphan claim re-pointed Claims processor | CLM-431125 → UHC-75752-29 (Philip Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005681 | Orphan claim re-pointed Claims processor | CLM-428212 → UHC-43401-37 (Carl Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005682 | Orphan claim re-pointed Claims processor | CLM-419871 → UHC-11034-93 (Sofia Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005683 | Orphan claim re-pointed Claims processor | CLM-418055 → UHC-48865-86 (Karen Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005684 | Orphan claim re-pointed Claims processor | CLM-400153 → UHC-50573-60 (Joseph Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005685 | Orphan claim re-pointed Claims processor | CLM-424912 → UHC-19333-94 (Isabella Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005686 | Orphan claim re-pointed Claims processor | CLM-415043 → UHC-52374-70 (Mei Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005687 | Orphan claim re-pointed Claims processor | CLM-420371 → UHC-78892-70 (Gabriel Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005688 | Orphan claim re-pointed Claims processor | CLM-428611 → UHC-10284-93 (Shirley Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005689 | Orphan claim re-pointed Claims processor | CLM-400266 → UHC-52389-49 (Charlotte Ortiz) |
| 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.