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-006440 | Orphan claim re-pointed Claims processor | CLM-416575 → UHC-59122-39 (Ethan Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006441 | Orphan claim re-pointed Claims processor | CLM-418994 → UHC-36349-47 (Aisha Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006442 | Orphan claim re-pointed Claims processor | CLM-420072 → UHC-78090-69 (Christine Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006443 | Orphan claim re-pointed Claims processor | CLM-423054 → UHC-16434-80 (Ken Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006444 | Orphan claim re-pointed Claims processor | CLM-416873 → UHC-81733-66 (Albert Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006445 | Orphan claim re-pointed Claims processor | CLM-419174 → UHC-24432-65 (Russell Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006446 | Orphan claim re-pointed Claims processor | CLM-407463 → UHC-68356-50 (Ana Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006447 | Orphan claim re-pointed Claims processor | CLM-409230 → UHC-28152-67 (Joe Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006448 | Orphan claim re-pointed Claims processor | CLM-414561 → UHC-39796-37 (Hanson Margaret) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006449 | Orphan claim re-pointed Claims processor | CLM-419685 → UHC-76302-57 (Diego Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006450 | Orphan claim re-pointed Claims processor | CLM-410816 → UHC-19980-14 (Stephen Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006451 | Orphan claim re-pointed Claims processor | CLM-432041 → UHC-39291-32 (Santiago Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006452 | Orphan claim re-pointed Claims processor | CLM-410684 → UHC-82828-61 (Teresa Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006453 | Orphan claim re-pointed Claims processor | CLM-431402 → UHC-27209-51 (Gary Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006454 | Orphan claim re-pointed Claims processor | CLM-420937 → UHC-74540-84 (Judith Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006455 | Orphan claim re-pointed Claims processor | CLM-429935 → UHC-24155-05 (Walter Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006456 | Orphan claim re-pointed Claims processor | CLM-403869 → UHC-64030-81 (Kyle Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006457 | Orphan claim re-pointed Claims processor | CLM-411014 → UHC-42385-49 (Brittany Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006458 | Orphan claim re-pointed Claims processor | CLM-417649 → UHC-50958-96 (Jacob Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006459 | Orphan claim re-pointed Claims processor | CLM-400629 → UHC-81966-47 (Alexander Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006460 | Orphan claim re-pointed Claims processor | CLM-422747 → UHC-73785-46 (Elizabeth Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006461 | Orphan claim re-pointed Claims processor | CLM-410146 → UHC-13273-59 (Theresa Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006462 | Orphan claim re-pointed Claims processor | CLM-420753 → UHC-54629-26 (Mariana Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006463 | Orphan claim re-pointed Claims processor | CLM-410528 → UHC-32682-08 (Diego Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006464 | Orphan claim re-pointed Claims processor | CLM-427031 → UHC-03053-87 (Rebecca Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006465 | Orphan claim re-pointed Claims processor | CLM-410770 → UHC-13519-75 (Abigail Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006466 | Orphan claim re-pointed Claims processor | CLM-416048 → UHC-73952-53 (Virginia Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006467 | Orphan claim re-pointed Claims processor | CLM-432712 → UHC-28510-22 (Janice Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006468 | Orphan claim re-pointed Claims processor | CLM-401304 → UHC-67277-92 (Santiago Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006469 | Orphan claim re-pointed Claims processor | CLM-424634 → UHC-40221-33 (Dylan Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006470 | Orphan claim re-pointed Claims processor | CLM-413167 → UHC-58593-18 (Logan Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006471 | Orphan claim re-pointed Claims processor | CLM-412399 → UHC-73546-71 (Scott Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006472 | Orphan claim re-pointed Claims processor | CLM-429863 → UHC-03108-13 (Madison Cok) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006473 | Orphan claim re-pointed Claims processor | CLM-419588 → UHC-89576-14 (Karen Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006474 | Orphan claim re-pointed Claims processor | CLM-403313 → UHC-34954-61 (Beverly Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006475 | Orphan claim re-pointed Claims processor | CLM-426454 → UHC-13952-43 (Margaret Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006476 | Orphan claim re-pointed Claims processor | CLM-416692 → UHC-33115-57 (Brian Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006477 | Orphan claim re-pointed Claims processor | CLM-409448 → UHC-90845-02 (Sara Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006478 | Orphan claim re-pointed Claims processor | CLM-425233 → UHC-95741-07 (Paul Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006479 | Orphan claim re-pointed Claims processor | CLM-419624 → UHC-61833-29 (Logan Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006480 | Orphan claim re-pointed Claims processor | CLM-432206 → UHC-15995-20 (Russell Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006481 | Orphan claim re-pointed Claims processor | CLM-410957 → UHC-21646-86 (Fatima Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006482 | Orphan claim re-pointed Claims processor | CLM-418711 → UHC-30537-94 (Janice West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006483 | Orphan claim re-pointed Claims processor | CLM-430358 → UHC-77648-76 (Jean Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006484 | Orphan claim re-pointed Claims processor | CLM-401650 → UHC-99173-76 (Doris Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006485 | Orphan claim re-pointed Claims processor | CLM-427285 → UHC-03949-82 (Nathan Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006486 | Orphan claim re-pointed Claims processor | CLM-428956 → UHC-60761-77 (Jessica Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006487 | Orphan claim re-pointed Claims processor | CLM-422637 → UHC-97584-08 (Juan Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006488 | Orphan claim re-pointed Claims processor | CLM-408462 → UHC-01984-24 (Brenda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006489 | Orphan claim re-pointed Claims processor | CLM-409124 → UHC-27870-32 (Jennifer Bradley) |
| 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.