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-006340 | Orphan claim re-pointed Claims processor | CLM-427200 → UHC-75238-63 (Sharon Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006341 | Orphan claim re-pointed Claims processor | CLM-406656 → UHC-33854-74 (Alexander Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006342 | Orphan claim re-pointed Claims processor | CLM-426460 → UHC-39422-61 (Cynthia Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006343 | Orphan claim re-pointed Claims processor | CLM-400889 → UHC-77591-05 (Fatima Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006344 | Orphan claim re-pointed Claims processor | CLM-415018 → UHC-79863-33 (Kayla Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006345 | Orphan claim re-pointed Claims processor | CLM-428249 → UHC-22617-37 (Mark Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006346 | Orphan claim re-pointed Claims processor | CLM-431466 → UHC-67088-66 (Lori Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006347 | Orphan claim re-pointed Claims processor | CLM-422080 → UHC-20467-09 (Omar Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006348 | Orphan claim re-pointed Claims processor | CLM-421100 → UHC-59343-89 (Ryan Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006349 | Orphan claim re-pointed Claims processor | CLM-421192 → UHC-63850-64 (Sara Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006350 | Orphan claim re-pointed Claims processor | CLM-409904 → UHC-88592-44 (Amber Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006351 | Orphan claim re-pointed Claims processor | CLM-431913 → UHC-90571-23 (Michelle Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006352 | Orphan claim re-pointed Claims processor | CLM-404798 → UHC-06894-24 (Billy Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006353 | Orphan claim re-pointed Claims processor | CLM-414130 → UHC-09912-57 (Albert Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006354 | Orphan claim re-pointed Claims processor | CLM-416071 → UHC-43281-15 (Angela Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006355 | Orphan claim re-pointed Claims processor | CLM-409664 → UHC-08254-58 (Timothy Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006356 | Orphan claim re-pointed Claims processor | CLM-419722 → UHC-19329-14 (Theresa Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006357 | Orphan claim re-pointed Claims processor | CLM-406658 → UHC-97895-99 (Ronald Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006358 | Orphan claim re-pointed Claims processor | CLM-403569 → UHC-54035-72 (Dennis Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006359 | Orphan claim re-pointed Claims processor | CLM-427956 → UHC-30017-27 (Laura Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006360 | Orphan claim re-pointed Claims processor | CLM-425116 → UHC-19173-70 (Sean Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006361 | Orphan claim re-pointed Claims processor | CLM-401654 → UHC-96066-30 (Henry Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006362 | Orphan claim re-pointed Claims processor | CLM-400365 → UHC-77060-06 (Ana Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006363 | Orphan claim re-pointed Claims processor | CLM-417425 → UHC-46623-02 (Donna Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006364 | Orphan claim re-pointed Claims processor | CLM-425752 → UHC-12395-95 (Nicole Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006365 | Orphan claim re-pointed Claims processor | CLM-427796 → UHC-05394-63 (Christina Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006366 | Orphan claim re-pointed Claims processor | CLM-426138 → UHC-89486-51 (Shaaron Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006367 | Orphan claim re-pointed Claims processor | CLM-420086 → UHC-40806-34 (Betty Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006368 | Orphan claim re-pointed Claims processor | CLM-401790 → UHC-38852-43 (Walter Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006369 | Orphan claim re-pointed Claims processor | CLM-414127 → UHC-68065-70 (George Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006370 | Orphan claim re-pointed Claims processor | CLM-416682 → UHC-48642-30 (Kayla Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006371 | Orphan claim re-pointed Claims processor | CLM-431934 → UHC-33190-68 (Austin Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006372 | Orphan claim re-pointed Claims processor | CLM-420045 → UHC-49350-55 (Isabella Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006373 | Orphan claim re-pointed Claims processor | CLM-431178 → UHC-58544-19 (Carolyn George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006374 | Orphan claim re-pointed Claims processor | CLM-426121 → UHC-22906-03 (Janet Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006375 | Orphan claim re-pointed Claims processor | CLM-428182 → UHC-38703-93 (Judith Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006376 | Orphan claim re-pointed Claims processor | CLM-419499 → UHC-07066-33 (Mason Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006377 | Orphan claim re-pointed Claims processor | CLM-423282 → UHC-89788-22 (Heather Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006378 | Orphan claim re-pointed Claims processor | CLM-411439 → UHC-06212-91 (Brenda Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006379 | Orphan claim re-pointed Claims processor | CLM-427418 → UHC-09454-42 (Karen Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006380 | Orphan claim re-pointed Claims processor | CLM-416684 → UHC-74628-55 (Danielle Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006381 | Orphan claim re-pointed Claims processor | CLM-431171 → UHC-95327-83 (Paul Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006382 | Orphan claim re-pointed Claims processor | CLM-403964 → UHC-07860-94 (Joyce Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006383 | Orphan claim re-pointed Claims processor | CLM-417942 → UHC-70642-50 (Andrew Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006384 | Orphan claim re-pointed Claims processor | CLM-401584 → UHC-95759-83 (Wayne Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006385 | Orphan claim re-pointed Claims processor | CLM-431706 → UHC-56875-41 (Christine Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006386 | Orphan claim re-pointed Claims processor | CLM-408869 → UHC-73064-35 (Walter Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006387 | Orphan claim re-pointed Claims processor | CLM-423462 → UHC-55793-41 (Ashley Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006388 | Orphan claim re-pointed Claims processor | CLM-415291 → UHC-21639-91 (Kathryn Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006389 | Orphan claim re-pointed Claims processor | CLM-411129 → UHC-13273-39 (Nicole Hughes) |
| 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.