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-026617 | Duplicate member record retired Member services | Judy Hawkins: 2 enrollment records collapsed into UHC-88988-21 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026618 | Duplicate member record retired Member services | Joshua Simmons: 2 enrollment records collapsed into UHC-13424-53 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026619 | Duplicate member record retired Member services | Jenifer Edwards: 2 enrollment records collapsed into UHC-36162-50 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026620 | Duplicate member record retired Member services | Eric Bowman: 2 enrollment records collapsed into UHC-56333-05 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026621 | Duplicate member record retired Member services | Henry Rios: 2 enrollment records collapsed into UHC-91003-95 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026622 | Duplicate member record retired Member services | Jacqueline Robinson: 2 enrollment records collapsed into UHC-85264-95 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026623 | Duplicate member record retired Member services | Daniel Dixon: 2 enrollment records collapsed into UHC-45004-55 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026624 | Duplicate member record retired Member services | Roger Gonzalez: 2 enrollment records collapsed into UHC-13173-01 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026625 | Duplicate member record retired Member services | Patrick Jacoobs: 2 enrollment records collapsed into UHC-46572-14 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026626 | Duplicate member record retired Member services | Gregory Barnes: 2 enrollment records collapsed into UHC-73844-05 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026627 | Duplicate member record retired Member services | Bradley Burton: 2 enrollment records collapsed into UHC-71453-79 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026628 | Duplicate member record retired Member services | Alan Rice: 2 enrollment records collapsed into UHC-77693-50 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026629 | Duplicate member record retired Member services | Nicholas Fisher: 2 enrollment records collapsed into UHC-15949-50 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026630 | Duplicate member record retired Member services | Roger Castillo: 2 enrollment records collapsed into UHC-03372-25 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026631 | Duplicate member record retired Member services | Nancy Freeman: 2 enrollment records collapsed into UHC-47450-44 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026632 | Duplicate member record retired Member services | Bruce James: 2 enrollment records collapsed into UHC-10487-28 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026633 | Duplicate member record retired Member services | Anna Armstrong: 2 enrollment records collapsed into UHC-13629-03 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026634 | Duplicate member record retired Member services | Maria Wang: 2 enrollment records collapsed into UHC-42599-86 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026635 | Duplicate member record retired Member services | Joe Vargas: 2 enrollment records collapsed into UHC-78473-84 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026636 | Duplicate member record retired Member services | Shirley Dixon: 2 enrollment records collapsed into UHC-15098-65 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026637 | Duplicate member record retired Member services | Willie Walsh: 2 enrollment records collapsed into UHC-23657-23 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026638 | Duplicate member record retired Member services | Austin Hansen: 2 enrollment records collapsed into UHC-38354-03 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026639 | Duplicate member record retired Member services | Walter Johnson: 2 enrollment records collapsed into UHC-73620-14 |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-026640 | Duplicate member record retired Member services | Joyce Olson: 2 enrollment records collapsed into UHC-61535-21 |
| 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.