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-006390 | Orphan claim re-pointed Claims processor | CLM-409724 → UHC-81866-57 (Alan Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006391 | Orphan claim re-pointed Claims processor | CLM-427073 → UHC-77787-12 (Deborah Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006392 | Orphan claim re-pointed Claims processor | CLM-402357 → UHC-74681-79 (Philip Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006393 | Orphan claim re-pointed Claims processor | CLM-406132 → UHC-48973-10 (Kyle Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006394 | Orphan claim re-pointed Claims processor | CLM-421604 → UHC-28587-16 (Andrew Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006395 | Orphan claim re-pointed Claims processor | CLM-404005 → UHC-29740-76 (Ryan Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006396 | Orphan claim re-pointed Claims processor | CLM-405639 → UHC-07124-52 (Ruth Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006397 | Orphan claim re-pointed Claims processor | CLM-404061 → UHC-71322-95 (Lauren Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006398 | Orphan claim re-pointed Claims processor | CLM-414022 → UHC-08635-40 (Joe Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006399 | Orphan claim re-pointed Claims processor | CLM-400757 → UHC-59786-48 (Jennifer Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006400 | Orphan claim re-pointed Claims processor | CLM-412473 → UHC-65412-57 (Jake Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006401 | Orphan claim re-pointed Claims processor | CLM-407388 → UHC-20290-28 (Grace Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006402 | Orphan claim re-pointed Claims processor | CLM-400959 → UHC-15651-83 (Patricia Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006403 | Orphan claim re-pointed Claims processor | CLM-419219 → UHC-20139-14 (Alice Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006404 | Orphan claim re-pointed Claims processor | CLM-412334 → UHC-82124-06 (Keith McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006405 | Orphan claim re-pointed Claims processor | CLM-410006 → UHC-60458-38 (Gerald Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006406 | Orphan claim re-pointed Claims processor | CLM-420382 → UHC-83055-57 (Emily Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006407 | Orphan claim re-pointed Claims processor | CLM-403621 → UHC-06126-03 (Kenneth Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006408 | Orphan claim re-pointed Claims processor | CLM-423525 → UHC-46677-80 (Patel Pamela) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006409 | Orphan claim re-pointed Claims processor | CLM-429358 → UHC-48884-02 (Natalie Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006410 | Orphan claim re-pointed Claims processor | CLM-408981 → UHC-77997-41 (Eugene Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006411 | Orphan claim re-pointed Claims processor | CLM-403287 → UHC-86192-80 (Frances Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006412 | Orphan claim re-pointed Claims processor | CLM-420926 → UHC-18704-10 (Pamela Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006413 | Orphan claim re-pointed Claims processor | CLM-408144 → UHC-98486-13 (Charlotte Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006414 | Orphan claim re-pointed Claims processor | CLM-414285 → UHC-62910-31 (Megan Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006415 | Orphan claim re-pointed Claims processor | CLM-411035 → UHC-24941-46 (Arjun Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006416 | Orphan claim re-pointed Claims processor | CLM-418491 → UHC-39290-06 (Linda Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006417 | Orphan claim re-pointed Claims processor | CLM-429415 → UHC-76690-56 (Douglas Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006418 | Orphan claim re-pointed Claims processor | CLM-423295 → UHC-86873-43 (Adam Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006419 | Orphan claim re-pointed Claims processor | CLM-426765 → UHC-82369-83 (Katherine Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006420 | Orphan claim re-pointed Claims processor | CLM-400184 → UHC-36965-72 (Anthony Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006421 | Orphan claim re-pointed Claims processor | CLM-417996 → UHC-25155-17 (Ana Gant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006422 | Orphan claim re-pointed Claims processor | CLM-425645 → UHC-54707-20 (Roy Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006423 | Orphan claim re-pointed Claims processor | CLM-410934 → UHC-51170-46 (Jesse Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006424 | Orphan claim re-pointed Claims processor | CLM-417893 → UHC-17587-12 (Justin Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006425 | Orphan claim re-pointed Claims processor | CLM-417773 → UHC-01095-30 (Kathleen Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006426 | Orphan claim re-pointed Claims processor | CLM-401831 → UHC-16187-17 (Ryan Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006427 | Orphan claim re-pointed Claims processor | CLM-427706 → UHC-52666-57 (Elijah Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006428 | Orphan claim re-pointed Claims processor | CLM-422826 → UHC-88575-02 (Theresa Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006429 | Orphan claim re-pointed Claims processor | CLM-427616 → UHC-70116-01 (Matthew Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006430 | Orphan claim re-pointed Claims processor | CLM-403535 → UHC-30904-19 (Kevin Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006431 | Orphan claim re-pointed Claims processor | CLM-405692 → UHC-87845-70 (Santiago Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006432 | Orphan claim re-pointed Claims processor | CLM-403091 → UHC-81250-72 (Patricia Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006433 | Orphan claim re-pointed Claims processor | CLM-432774 → UHC-47935-63 (Barb Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006434 | Orphan claim re-pointed Claims processor | CLM-407267 → UHC-62055-42 (Kenneth Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006435 | Orphan claim re-pointed Claims processor | CLM-415106 → UHC-64207-18 (Emma White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006436 | Orphan claim re-pointed Claims processor | CLM-421257 → UHC-61130-89 (Dorothy Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006437 | Orphan claim re-pointed Claims processor | CLM-409445 → UHC-23755-18 (James Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006438 | Orphan claim re-pointed Claims processor | CLM-409837 → UHC-15476-72 (Joe Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006439 | Orphan claim re-pointed Claims processor | CLM-412008 → UHC-28458-04 (Gerald Jones) |
| 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.