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-006640 | Orphan claim re-pointed Claims processor | CLM-424954 → UHC-35917-23 (Nancy Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006641 | Orphan claim re-pointed Claims processor | CLM-411549 → UHC-08946-13 (Gabriel Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006642 | Orphan claim re-pointed Claims processor | CLM-405365 → UHC-25287-21 (Elijah Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006643 | Orphan claim re-pointed Claims processor | CLM-424088 → UHC-89750-63 (Tyler Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006644 | Orphan claim re-pointed Claims processor | CLM-407148 → UHC-38319-19 (Hannah Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006645 | Orphan claim re-pointed Claims processor | CLM-416081 → UHC-80041-28 (Angela Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006646 | Orphan claim re-pointed Claims processor | CLM-424043 → UHC-20832-08 (Alexander Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006647 | Orphan claim re-pointed Claims processor | CLM-427906 → UHC-74207-75 (Emma Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006648 | Orphan claim re-pointed Claims processor | CLM-415704 → UHC-25722-63 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006649 | Orphan claim re-pointed Claims processor | CLM-432140 → UHC-97290-31 (Roger Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006650 | Orphan claim re-pointed Claims processor | CLM-401482 → UHC-24743-25 (Ann Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006651 | Orphan claim re-pointed Claims processor | CLM-413915 → UHC-01218-90 (Dorothy Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006652 | Orphan claim re-pointed Claims processor | CLM-418112 → UHC-95097-30 (Arthur Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006653 | Orphan claim re-pointed Claims processor | CLM-413549 → UHC-46841-03 (Rachel Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006654 | Orphan claim re-pointed Claims processor | CLM-427301 → UHC-17983-86 (Logan Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006655 | Orphan claim re-pointed Claims processor | CLM-409967 → UHC-08632-94 (Henry Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006656 | Orphan claim re-pointed Claims processor | CLM-405958 → UHC-58253-49 (Rachel West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006657 | Orphan claim re-pointed Claims processor | CLM-415987 → UHC-27825-83 (Patrick Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006658 | Orphan claim re-pointed Claims processor | CLM-416471 → UHC-76175-26 (Donna Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006659 | Orphan claim re-pointed Claims processor | CLM-420370 → UHC-64022-98 (Albert Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006660 | Orphan claim re-pointed Claims processor | CLM-410371 → UHC-41438-71 (Ralph Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006661 | Orphan claim re-pointed Claims processor | CLM-406684 → UHC-79617-30 (Virginia Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006662 | Orphan claim re-pointed Claims processor | CLM-427689 → UHC-78757-55 (Timothy Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006663 | Orphan claim re-pointed Claims processor | CLM-417163 → UHC-24502-41 (Luis Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006664 | Orphan claim re-pointed Claims processor | CLM-413421 → UHC-64405-22 (Noah Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006665 | Orphan claim re-pointed Claims processor | CLM-426367 → UHC-15488-51 (Mei Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006666 | Orphan claim re-pointed Claims processor | CLM-400766 → UHC-07622-81 (Samuel Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006667 | Orphan claim re-pointed Claims processor | CLM-411834 → UHC-67677-60 (Sarah Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006668 | Orphan claim re-pointed Claims processor | CLM-415651 → UHC-42406-33 (Joshua Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006669 | Orphan claim re-pointed Claims processor | CLM-409815 → UHC-71563-08 (Matthew Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006670 | Orphan claim re-pointed Claims processor | CLM-405104 → UHC-46284-07 (Amanda Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006671 | Orphan claim re-pointed Claims processor | CLM-409133 → UHC-78843-89 (Don Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006672 | Orphan claim re-pointed Claims processor | CLM-419382 → UHC-18151-19 (Catherine Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006673 | Orphan claim re-pointed Claims processor | CLM-400227 → UHC-87537-12 (Evelyn Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006674 | Orphan claim re-pointed Claims processor | CLM-403817 → UHC-20741-25 (Jesse Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006675 | Orphan claim re-pointed Claims processor | CLM-422122 → UHC-96592-26 (Mark Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006676 | Orphan claim re-pointed Claims processor | CLM-431617 → UHC-72010-71 (Daniel Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006677 | Orphan claim re-pointed Claims processor | CLM-427035 → UHC-14530-18 (Luis Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006678 | Orphan claim re-pointed Claims processor | CLM-425270 → UHC-11065-29 (Bruce Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006679 | Orphan claim re-pointed Claims processor | CLM-430294 → UHC-73490-52 (Helen Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006680 | Orphan claim re-pointed Claims processor | CLM-415038 → UHC-54030-96 (Carlos Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006681 | Orphan claim re-pointed Claims processor | CLM-418628 → UHC-05969-13 (John Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006682 | Orphan claim re-pointed Claims processor | CLM-400786 → UHC-57559-48 (James Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006683 | Orphan claim re-pointed Claims processor | CLM-405556 → UHC-59137-20 (Brian Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006684 | Orphan claim re-pointed Claims processor | CLM-418105 → UHC-57452-96 (Joshua Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006685 | Orphan claim re-pointed Claims processor | CLM-408681 → UHC-06628-52 (Christian Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006686 | Orphan claim re-pointed Claims processor | CLM-402120 → UHC-74464-51 (Ray Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006687 | Orphan claim re-pointed Claims processor | CLM-424289 → UHC-86475-61 (Mei King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006688 | Orphan claim re-pointed Claims processor | CLM-403136 → UHC-74882-41 (Hannah Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006689 | Orphan claim re-pointed Claims processor | CLM-414295 → UHC-05912-11 (Camila Ortiz) |
| 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.