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-006540 | Orphan claim re-pointed Claims processor | CLM-424207 → UHC-53662-77 (Linda Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006541 | Orphan claim re-pointed Claims processor | CLM-405274 → UHC-53272-81 (Willie Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006542 | Orphan claim re-pointed Claims processor | CLM-423786 → UHC-47709-74 (Grace Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006543 | Orphan claim re-pointed Claims processor | CLM-419334 → UHC-64701-90 (Gregory James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006544 | Orphan claim re-pointed Claims processor | CLM-411629 → UHC-25626-75 (Helen West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006545 | Orphan claim re-pointed Claims processor | CLM-407597 → UHC-74481-70 (Beverly Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006546 | Orphan claim re-pointed Claims processor | CLM-432261 → UHC-71373-79 (Julie Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006547 | Orphan claim re-pointed Claims processor | CLM-429056 → UHC-54406-84 (Billy Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006548 | Orphan claim re-pointed Claims processor | CLM-430873 → UHC-04410-99 (Michelle Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006549 | Orphan claim re-pointed Claims processor | CLM-400319 → UHC-62796-06 (Anthony Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006550 | Orphan claim re-pointed Claims processor | CLM-400609 → UHC-30577-22 (Kenneth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006551 | Orphan claim re-pointed Claims processor | CLM-416798 → UHC-60254-75 (Frank Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006552 | Orphan claim re-pointed Claims processor | CLM-402225 → UHC-70976-57 (Kimberly Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006553 | Orphan claim re-pointed Claims processor | CLM-405529 → UHC-66614-26 (Denise Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006554 | Orphan claim re-pointed Claims processor | CLM-416747 → UHC-44585-61 (Larry Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006555 | Orphan claim re-pointed Claims processor | CLM-422351 → UHC-49069-01 (Matthew Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006556 | Orphan claim re-pointed Claims processor | CLM-419302 → UHC-22662-71 (Adam Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006557 | Orphan claim re-pointed Claims processor | CLM-403532 → UHC-45932-54 (Mateo Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006558 | Orphan claim re-pointed Claims processor | CLM-430470 → UHC-25311-18 (Kathryn Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006559 | Orphan claim re-pointed Claims processor | CLM-400618 → UHC-81856-96 (Gary Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006560 | Orphan claim re-pointed Claims processor | CLM-419358 → UHC-52218-29 (Barbara Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006561 | Orphan claim re-pointed Claims processor | CLM-425981 → UHC-64643-77 (Gerald McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006562 | Orphan claim re-pointed Claims processor | CLM-431142 → UHC-45290-96 (Roger Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006563 | Orphan claim re-pointed Claims processor | CLM-410824 → UHC-96374-15 (Christian Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006564 | Orphan claim re-pointed Claims processor | CLM-431756 → UHC-65635-70 (Ann Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006565 | Orphan claim re-pointed Claims processor | CLM-400056 → UHC-43942-38 (Samantha Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006566 | Orphan claim re-pointed Claims processor | CLM-407382 → UHC-21518-10 (Santiago Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006567 | Orphan claim re-pointed Claims processor | CLM-427717 → UHC-59486-30 (David Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006568 | Orphan claim re-pointed Claims processor | CLM-418280 → UHC-40140-87 (Beverly Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006569 | Orphan claim re-pointed Claims processor | CLM-415374 → UHC-70639-44 (Jennifer Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006570 | Orphan claim re-pointed Claims processor | CLM-431721 → UHC-24034-56 (Joan Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006571 | Orphan claim re-pointed Claims processor | CLM-411985 → UHC-74637-63 (Aishha Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006572 | Orphan claim re-pointed Claims processor | CLM-409513 → UHC-74702-59 (Abigail Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006573 | Orphan claim re-pointed Claims processor | CLM-421735 → UHC-80133-34 (Luis Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006574 | Orphan claim re-pointed Claims processor | CLM-414451 → UHC-13952-38 (Yuki Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006575 | Orphan claim re-pointed Claims processor | CLM-403757 → UHC-01798-59 (Justin Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006576 | Orphan claim re-pointed Claims processor | CLM-431962 → UHC-03242-36 (Ralph Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006577 | Orphan claim re-pointed Claims processor | CLM-424624 → UHC-02015-72 (Christian Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006578 | Orphan claim re-pointed Claims processor | CLM-420081 → UHC-53253-11 (Kimberly Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006579 | Orphan claim re-pointed Claims processor | CLM-424351 → UHC-87114-24 (Dennis Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006580 | Orphan claim re-pointed Claims processor | CLM-406515 → UHC-58654-72 (Virginia Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006581 | Orphan claim re-pointed Claims processor | CLM-402906 → UHC-06664-40 (Janice Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006582 | Orphan claim re-pointed Claims processor | CLM-425118 → UHC-39317-97 (Alice Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006583 | Orphan claim re-pointed Claims processor | CLM-425183 → UHC-65473-87 (Henry Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006584 | Orphan claim re-pointed Claims processor | CLM-429809 → UHC-24187-59 (Denise Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006585 | Orphan claim re-pointed Claims processor | CLM-410070 → UHC-26564-74 (Natalie McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006586 | Orphan claim re-pointed Claims processor | CLM-408704 → UHC-40234-04 (Amanda Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006587 | Orphan claim re-pointed Claims processor | CLM-428313 → UHC-41409-07 (Andrew McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006588 | Orphan claim re-pointed Claims processor | CLM-416942 → UHC-53088-33 (Dorothy Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006589 | Orphan claim re-pointed Claims processor | CLM-428549 → UHC-70852-06 (Shirley Ortega) |
| 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.