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-006590 | Orphan claim re-pointed Claims processor | CLM-430453 → UHC-05137-74 (Ralph Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006591 | Orphan claim re-pointed Claims processor | CLM-418446 → UHC-23443-73 (Maria Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006592 | Orphan claim re-pointed Claims processor | CLM-409294 → UHC-40363-22 (Stephanie Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006593 | Orphan claim re-pointed Claims processor | CLM-401854 → UHC-58248-42 (Edward Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006594 | Orphan claim re-pointed Claims processor | CLM-429782 → UHC-26994-62 (David Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006595 | Orphan claim re-pointed Claims processor | CLM-414429 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006596 | Orphan claim re-pointed Claims processor | CLM-415643 → UHC-23041-70 (Austin Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006597 | Orphan claim re-pointed Claims processor | CLM-412636 → UHC-56622-34 (Mateo Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006598 | Orphan claim re-pointed Claims processor | CLM-409110 → UHC-23250-48 (Donald Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006599 | Orphan claim re-pointed Claims processor | CLM-430907 → UHC-48436-70 (Eugene Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006600 | Orphan claim re-pointed Claims processor | CLM-419254 → UHC-86844-01 (Christopher Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006601 | Orphan claim re-pointed Claims processor | CLM-426289 → UHC-96050-09 (Laura Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006602 | Orphan claim re-pointed Claims processor | CLM-407362 → UHC-50068-89 (Gary Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006603 | Orphan claim re-pointed Claims processor | CLM-410611 → UHC-19999-31 (Gregory Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006604 | Orphan claim re-pointed Claims processor | CLM-424710 → UHC-07807-62 (Dylan Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006605 | Orphan claim re-pointed Claims processor | CLM-409863 → UHC-68463-16 (Terrry Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006606 | Orphan claim re-pointed Claims processor | CLM-424913 → UHC-19333-94 (Isabella Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006607 | Orphan claim re-pointed Claims processor | CLM-403229 → UHC-28097-08 (Megan Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006608 | Orphan claim re-pointed Claims processor | CLM-418087 → UHC-42099-41 (Margaret Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006609 | Orphan claim re-pointed Claims processor | CLM-420299 → UHC-59686-02 (Diana Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006610 | Orphan claim re-pointed Claims processor | CLM-406598 → UHC-13185-09 (Emma Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006611 | Orphan claim re-pointed Claims processor | CLM-431173 → UHC-33328-14 (Virginia Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006612 | Orphan claim re-pointed Claims processor | CLM-423914 → UHC-98691-32 (Janice Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006613 | Orphan claim re-pointed Claims processor | CLM-413808 → UHC-32902-31 (Sarah Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006614 | Orphan claim re-pointed Claims processor | CLM-404919 → UHC-88136-88 (Cheryl Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006615 | Orphan claim re-pointed Claims processor | CLM-426928 → UHC-66065-50 (Sean Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006616 | Orphan claim re-pointed Claims processor | CLM-402192 → UHC-57261-42 (Lawrence Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006617 | Orphan claim re-pointed Claims processor | CLM-432096 → UHC-53955-09 (Wei Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006618 | Orphan claim re-pointed Claims processor | CLM-426950 → UHC-06715-98 (Karen Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006619 | Orphan claim re-pointed Claims processor | CLM-404705 → UHC-81150-79 (Sean Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006620 | Orphan claim re-pointed Claims processor | CLM-431298 → UHC-31999-53 (Olivia Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006621 | Orphan claim re-pointed Claims processor | CLM-427670 → UHC-29582-45 (Jonathan Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006622 | Orphan claim re-pointed Claims processor | CLM-420403 → UHC-51717-73 (Carol Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006623 | Orphan claim re-pointed Claims processor | CLM-401418 → UHC-98347-36 (Catherine Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006624 | Orphan claim re-pointed Claims processor | CLM-414400 → UHC-71463-79 (Amanda Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006625 | Orphan claim re-pointed Claims processor | CLM-417751 → UHC-91470-77 (Heather Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006626 | Orphan claim re-pointed Claims processor | CLM-409014 → UHC-18863-18 (Bradley Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006627 | Orphan claim re-pointed Claims processor | CLM-401255 → UHC-04938-69 (Brandon Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006628 | Orphan claim re-pointed Claims processor | CLM-429473 → UHC-57140-31 (Albert Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006629 | Orphan claim re-pointed Claims processor | CLM-409091 → UHC-22422-34 (Kimberly Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006630 | Orphan claim re-pointed Claims processor | CLM-413365 → UHC-02982-41 (Kevin Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006631 | Orphan claim re-pointed Claims processor | CLM-423860 → UHC-09978-13 (Billy Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006632 | Orphan claim re-pointed Claims processor | CLM-411137 → UHC-73026-62 (Vincent Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006633 | Orphan claim re-pointed Claims processor | CLM-407149 → UHC-38319-19 (Hannah Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006634 | Orphan claim re-pointed Claims processor | CLM-424361 → UHC-15386-32 (Pamela Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006635 | Orphan claim re-pointed Claims processor | CLM-430867 → UHC-22981-87 (Dennis Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006636 | Orphan claim re-pointed Claims processor | CLM-405289 → UHC-97566-56 (Catherine Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006637 | Orphan claim re-pointed Claims processor | CLM-408585 → UHC-24341-03 (Doris West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006638 | Orphan claim re-pointed Claims processor | CLM-425638 → UHC-17486-97 (Heather Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006639 | Orphan claim re-pointed Claims processor | CLM-413176 → UHC-47386-60 (Kathleen Simpson) |
| 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.