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-005690 | Orphan claim re-pointed Claims processor | CLM-405180 → UHC-97377-90 (Marilyn Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005691 | Orphan claim re-pointed Claims processor | CLM-418880 → UHC-85876-46 (Austin Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005692 | Orphan claim re-pointed Claims processor | CLM-428023 → UHC-43990-46 (Sharon Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005693 | Orphan claim re-pointed Claims processor | CLM-409111 → UHC-38123-88 (Zachary Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005694 | Orphan claim re-pointed Claims processor | CLM-425411 → UHC-57483-84 (Frances Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005695 | Orphan claim re-pointed Claims processor | CLM-412870 → UHC-46507-42 (Nancy Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005696 | Orphan claim re-pointed Claims processor | CLM-428959 → UHC-70161-33 (Robert Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005697 | Orphan claim re-pointed Claims processor | CLM-420096 → UHC-19295-48 (Hiroshi Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005698 | Orphan claim re-pointed Claims processor | CLM-408284 → UHC-78528-57 (Betty Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005699 | Orphan claim re-pointed Claims processor | CLM-419787 → UHC-50265-96 (Kvein Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005700 | Orphan claim re-pointed Claims processor | CLM-428203 → UHC-31520-38 (Lawrence Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005701 | Orphan claim re-pointed Claims processor | CLM-429572 → UHC-15588-86 (Jonathan Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005702 | Orphan claim re-pointed Claims processor | CLM-423455 → UHC-87978-96 (Diego Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005703 | Orphan claim re-pointed Claims processor | CLM-417200 → UHC-16937-14 (Russell Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005704 | Orphan claim re-pointed Claims processor | CLM-429927 → UHC-87847-39 (Shirley Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005705 | Orphan claim re-pointed Claims processor | CLM-412803 → UHC-18255-97 (Wei Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005706 | Orphan claim re-pointed Claims processor | CLM-429456 → UHC-79343-17 (Jose Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005707 | Orphan claim re-pointed Claims processor | CLM-425809 → UHC-44852-79 (Gary Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005708 | Orphan claim re-pointed Claims processor | CLM-415907 → UHC-91345-99 (Alexis Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005709 | Orphan claim re-pointed Claims processor | CLM-409827 → UHC-87084-73 (Melissa Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005710 | Orphan claim re-pointed Claims processor | CLM-400594 → UHC-76560-14 (Harold West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005711 | Orphan claim re-pointed Claims processor | CLM-424546 → UHC-45944-04 (Michael Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005712 | Orphan claim re-pointed Claims processor | CLM-425328 → UHC-34873-58 (Amber Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005713 | Orphan claim re-pointed Claims processor | CLM-428418 → UHC-22463-20 (Diana Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005714 | Orphan claim re-pointed Claims processor | CLM-416949 → UHC-67461-55 (Janice Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005715 | Orphan claim re-pointed Claims processor | CLM-413583 → UHC-58059-62 (Jacqueline Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005716 | Orphan claim re-pointed Claims processor | CLM-430488 → UHC-82518-76 (Sarah Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005717 | Orphan claim re-pointed Claims processor | CLM-408322 → UHC-81524-61 (Valentina Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005718 | Orphan claim re-pointed Claims processor | CLM-424748 → UHC-45211-18 (Elizabeth Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005719 | Orphan claim re-pointed Claims processor | CLM-404826 → UHC-36017-42 (Marcus Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005720 | Orphan claim re-pointed Claims processor | CLM-405193 → UHC-46402-70 (Benjamin Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005721 | Orphan claim re-pointed Claims processor | CLM-431325 → UHC-46514-85 (Jack Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005722 | Orphan claim re-pointed Claims processor | CLM-405780 → UHC-22452-89 (Peter Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005723 | Orphan claim re-pointed Claims processor | CLM-415431 → UHC-66461-69 (Elizabeth Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005724 | Orphan claim re-pointed Claims processor | CLM-417616 → UHC-12188-14 (Bobby Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005725 | Orphan claim re-pointed Claims processor | CLM-426522 → UHC-56084-13 (Steven Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005726 | Orphan claim re-pointed Claims processor | CLM-426356 → UHC-75258-31 (Carolyn Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005727 | Orphan claim re-pointed Claims processor | CLM-432489 → UHC-03866-37 (Daniel Sannders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005728 | Orphan claim re-pointed Claims processor | CLM-423659 → UHC-54456-13 (Gloria Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005729 | Orphan claim re-pointed Claims processor | CLM-421616 → UHC-70359-74 (Victoria Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005730 | Orphan claim re-pointed Claims processor | CLM-422091 → UHC-00966-58 (Daniel Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005731 | Orphan claim re-pointed Claims processor | CLM-419295 → UHC-98804-07 (Keith Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005732 | Orphan claim re-pointed Claims processor | CLM-426604 → UHC-01832-24 (Barbara Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005733 | Orphan claim re-pointed Claims processor | CLM-406731 → UHC-90446-52 (Brenda Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005734 | Orphan claim re-pointed Claims processor | CLM-422741 → UHC-48579-46 (Megan West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005735 | Orphan claim re-pointed Claims processor | CLM-430156 → UHC-68634-52 (David Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005736 | Orphan claim re-pointed Claims processor | CLM-403714 → UHC-79829-71 (Lisa Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005737 | Orphan claim re-pointed Claims processor | CLM-416493 → UHC-63291-28 (Ryan Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005738 | Orphan claim re-pointed Claims processor | CLM-431699 → UHC-14575-83 (Ahmed Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005739 | Orphan claim re-pointed Claims processor | CLM-420550 → UHC-68314-07 (Tyler Meyer) |
| 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.