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-006290 | Orphan claim re-pointed Claims processor | CLM-411531 → UHC-28703-46 (Beverly Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006291 | Orphan claim re-pointed Claims processor | CLM-403090 → UHC-81250-72 (Patricia Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006292 | Orphan claim re-pointed Claims processor | CLM-410693 → UHC-84665-74 (David Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006293 | Orphan claim re-pointed Claims processor | CLM-428757 → UHC-13138-62 (Gabriel Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006294 | Orphan claim re-pointed Claims processor | CLM-406469 → UHC-48765-83 (Shirley Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006295 | Orphan claim re-pointed Claims processor | CLM-409413 → UHC-95872-02 (Lori Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006296 | Orphan claim re-pointed Claims processor | CLM-407425 → UHC-39892-95 (Kyle Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006297 | Orphan claim re-pointed Claims processor | CLM-416914 → UHC-31740-79 (Liz Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006298 | Orphan claim re-pointed Claims processor | CLM-422280 → UHC-59633-24 (Maria Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006299 | Orphan claim re-pointed Claims processor | CLM-404509 → UHC-80230-70 (Daniel Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006300 | Orphan claim re-pointed Claims processor | CLM-424167 → UHC-44839-36 (Mark Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006301 | Orphan claim re-pointed Claims processor | CLM-410327 → UHC-10708-73 (Brian Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006302 | Orphan claim re-pointed Claims processor | CLM-430594 → UHC-58072-95 (Susan Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006303 | Orphan claim re-pointed Claims processor | CLM-408085 → UHC-63754-29 (Ryan Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006304 | Orphan claim re-pointed Claims processor | CLM-420508 → UHC-34589-55 (Judith Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006305 | Orphan claim re-pointed Claims processor | CLM-414145 → UHC-35506-90 (Kelly Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006306 | Orphan claim re-pointed Claims processor | CLM-422490 → UHC-08655-80 (Kevin Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006307 | Orphan claim re-pointed Claims processor | CLM-400081 → UHC-44743-32 (Jonathan Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006308 | Orphan claim re-pointed Claims processor | CLM-405454 → UHC-21109-44 (Rachel Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006309 | Orphan claim re-pointed Claims processor | CLM-401786 → UHC-40299-97 (Madison Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006310 | Orphan claim re-pointed Claims processor | CLM-414248 → UHC-93744-90 (Logan Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006311 | Orphan claim re-pointed Claims processor | CLM-402479 → UHC-24096-20 (Lawrence Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006312 | Orphan claim re-pointed Claims processor | CLM-417713 → UHC-34891-72 (Lori Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006313 | Orphan claim re-pointed Claims processor | CLM-427340 → UHC-63493-18 (Brian Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006314 | Orphan claim re-pointed Claims processor | CLM-406978 → UHC-98002-75 (Ralph Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006315 | Orphan claim re-pointed Claims processor | CLM-402319 → UHC-29266-34 (Alan Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006316 | Orphan claim re-pointed Claims processor | CLM-428930 → UHC-14551-01 (Sean Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006317 | Orphan claim re-pointed Claims processor | CLM-408314 → UHC-29708-97 (Tyler Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006318 | Orphan claim re-pointed Claims processor | CLM-408214 → UHC-58932-47 (Jean Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006319 | Orphan claim re-pointed Claims processor | CLM-422544 → UHC-05896-07 (Jonathan Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006320 | Orphan claim re-pointed Claims processor | CLM-418454 → UHC-65651-73 (Jordan Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006321 | Orphan claim re-pointed Claims processor | CLM-417593 → UHC-92828-80 (James Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006322 | Orphan claim re-pointed Claims processor | CLM-425357 → UHC-22917-70 (Patricia Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006323 | Orphan claim re-pointed Claims processor | CLM-430202 → UHC-90961-55 (Gabriel Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006324 | Orphan claim re-pointed Claims processor | CLM-403768 → UHC-10935-86 (Amber Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006325 | Orphan claim re-pointed Claims processor | CLM-412717 → UHC-83353-54 (Justin Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006326 | Orphan claim re-pointed Claims processor | CLM-410601 → UHC-74026-83 (Paul Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006327 | Orphan claim re-pointed Claims processor | CLM-418578 → UHC-44307-53 (Keith Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006328 | Orphan claim re-pointed Claims processor | CLM-427940 → UHC-16525-76 (Christina Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006329 | Orphan claim re-pointed Claims processor | CLM-402552 → UHC-61498-82 (Sara Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006330 | Orphan claim re-pointed Claims processor | CLM-427239 → UHC-80971-11 (Russell King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006331 | Orphan claim re-pointed Claims processor | CLM-413154 → UHC-11544-93 (Aaron Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006332 | Orphan claim re-pointed Claims processor | CLM-425449 → UHC-49523-70 (Judy Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006333 | Orphan claim re-pointed Claims processor | CLM-402533 → UHC-23088-75 (Andrea Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006334 | Orphan claim re-pointed Claims processor | CLM-425319 → UHC-95632-60 (Gerald Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006335 | Orphan claim re-pointed Claims processor | CLM-400964 → UHC-11904-51 (Betty Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006336 | Orphan claim re-pointed Claims processor | CLM-425884 → UHC-34809-40 (Raymond Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006337 | Orphan claim re-pointed Claims processor | CLM-418952 → UHC-97434-51 (Omar Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006338 | Orphan claim re-pointed Claims processor | CLM-421636 → UHC-59116-79 (Willie Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006339 | Orphan claim re-pointed Claims processor | CLM-429179 → UHC-31006-11 (Megan Richardson) |
| 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.