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-006490 | Orphan claim re-pointed Claims processor | CLM-429771 → UHC-43808-81 (Jean Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006491 | Orphan claim re-pointed Claims processor | CLM-431501 → UHC-06739-36 (Evelyn Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006492 | Orphan claim re-pointed Claims processor | CLM-419364 → UHC-07269-10 (Sofia Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006493 | Orphan claim re-pointed Claims processor | CLM-426227 → UHC-72872-02 (Samantha Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006494 | Orphan claim re-pointed Claims processor | CLM-416173 → UHC-47916-16 (Ethan Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006495 | Orphan claim re-pointed Claims processor | CLM-403455 → UHC-57070-14 (Roy Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006496 | Orphan claim re-pointed Claims processor | CLM-431464 → UHC-16807-44 (Larry Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006497 | Orphan claim re-pointed Claims processor | CLM-408735 → UHC-07444-96 (Bryan Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006498 | Orphan claim re-pointed Claims processor | CLM-418080 → UHC-79666-91 (Edward Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006499 | Orphan claim re-pointed Claims processor | CLM-401182 → UHC-89423-86 (Diego Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006500 | Orphan claim re-pointed Claims processor | CLM-425515 → UHC-18011-83 (Walter Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006501 | Orphan claim re-pointed Claims processor | CLM-418666 → UHC-82723-91 (Christian James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006502 | Orphan claim re-pointed Claims processor | CLM-425558 → UHC-87911-25 (Bobby Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006503 | Orphan claim re-pointed Claims processor | CLM-409115 → UHC-68068-92 (Sean Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006504 | Orphan claim re-pointed Claims processor | CLM-400169 → UHC-15231-47 (Paul Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006505 | Orphan claim re-pointed Claims processor | CLM-429899 → UHC-27590-46 (Jacob Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006506 | Orphan claim re-pointed Claims processor | CLM-413932 → UHC-86947-07 (Timothy Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006507 | Orphan claim re-pointed Claims processor | CLM-431271 → UHC-53720-04 (Margaret Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006508 | Orphan claim re-pointed Claims processor | CLM-409310 → UHC-30817-37 (Cheryl Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006509 | Orphan claim re-pointed Claims processor | CLM-427483 → UHC-95042-59 (Wayne Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006510 | Orphan claim re-pointed Claims processor | CLM-425747 → UHC-12376-13 (Hannah Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006511 | Orphan claim re-pointed Claims processor | CLM-417148 → UHC-77064-16 (Kayla Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006512 | Orphan claim re-pointed Claims processor | CLM-406256 → UHC-88685-49 (Linda Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006513 | Orphan claim re-pointed Claims processor | CLM-431442 → UHC-81453-36 (Emily Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006514 | Orphan claim re-pointed Claims processor | CLM-431582 → UHC-45541-40 (Aaron Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006515 | Orphan claim re-pointed Claims processor | CLM-428163 → UHC-98443-74 (Brandon Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006516 | Orphan claim re-pointed Claims processor | CLM-418003 → UHC-57515-46 (Betty Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006517 | Orphan claim re-pointed Claims processor | CLM-407337 → UHC-68589-33 (Elijah Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006518 | Orphan claim re-pointed Claims processor | CLM-407205 → UHC-44926-42 (Sara Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006519 | Orphan claim re-pointed Claims processor | CLM-411059 → UHC-24608-69 (Mateo Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006520 | Orphan claim re-pointed Claims processor | CLM-420392 → UHC-42580-56 (Brittany Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006521 | Orphan claim re-pointed Claims processor | CLM-431216 → UHC-22023-59 (Sean Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006522 | Orphan claim re-pointed Claims processor | CLM-409071 → UHC-25511-74 (Santiago McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006523 | Orphan claim re-pointed Claims processor | CLM-418571 → UHC-58484-22 (Susan Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006524 | Orphan claim re-pointed Claims processor | CLM-404640 → UHC-42879-41 (Douglas Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006525 | Orphan claim re-pointed Claims processor | CLM-426853 → UHC-51529-10 (Jimmy Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006526 | Orphan claim re-pointed Claims processor | CLM-420245 → UHC-52979-83 (Ethan Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006527 | Orphan claim re-pointed Claims processor | CLM-425365 → UHC-23902-55 (Jnaet Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006528 | Orphan claim re-pointed Claims processor | CLM-410438 → UHC-82278-33 (Martha Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006529 | Orphan claim re-pointed Claims processor | CLM-408086 → UHC-63754-29 (Ryan Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006530 | Orphan claim re-pointed Claims processor | CLM-426507 → UHC-96381-04 (Jordan Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006531 | Orphan claim re-pointed Claims processor | CLM-414811 → UHC-30785-89 (Deborah Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006532 | Orphan claim re-pointed Claims processor | CLM-429008 → UHC-36432-76 (Peter Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006533 | Orphan claim re-pointed Claims processor | CLM-426594 → UHC-52659-75 (Keith Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006534 | Orphan claim re-pointed Claims processor | CLM-410311 → UHC-27089-19 (Deborah Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006535 | Orphan claim re-pointed Claims processor | CLM-403406 → UHC-20825-98 (Mariana Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006536 | Orphan claim re-pointed Claims processor | CLM-431210 → UHC-35273-61 (Arjun Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006537 | Orphan claim re-pointed Claims processor | CLM-432569 → UHC-83352-41 (Stephanie Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006538 | Orphan claim re-pointed Claims processor | CLM-400409 → UHC-34435-37 (Mary Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006539 | Orphan claim re-pointed Claims processor | CLM-417047 → UHC-64875-75 (Lori Nunez) |
| 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.