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-006690 | Orphan claim re-pointed Claims processor | CLM-425108 → UHC-26275-01 (Hiroshi Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006691 | Orphan claim re-pointed Claims processor | CLM-411140 → UHC-44848-39 (Roy Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006692 | Orphan claim re-pointed Claims processor | CLM-423391 → UHC-44535-99 (Hiroshi Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006693 | Orphan claim re-pointed Claims processor | CLM-421860 → UHC-15847-88 (Judith Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006694 | Orphan claim re-pointed Claims processor | CLM-418720 → UHC-11833-22 (Ralph Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006695 | Orphan claim re-pointed Claims processor | CLM-419356 → UHC-07141-01 (Wei Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006696 | Orphan claim re-pointed Claims processor | CLM-427490 → UHC-29672-58 (Kyle Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006697 | Orphan claim re-pointed Claims processor | CLM-405562 → UHC-20430-16 (Grace Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006698 | Orphan claim re-pointed Claims processor | CLM-420574 → UHC-90230-78 (Theresa Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006699 | Orphan claim re-pointed Claims processor | CLM-430467 → UHC-12576-48 (Lisa Jorrdan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006700 | Orphan claim re-pointed Claims processor | CLM-408612 → UHC-65445-38 (Matthew Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006701 | Orphan claim re-pointed Claims processor | CLM-408584 → UHC-51657-47 (Mei Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006702 | Orphan claim re-pointed Claims processor | CLM-414849 → UHC-75410-20 (Pamela Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006703 | Orphan claim re-pointed Claims processor | CLM-432372 → UHC-36196-33 (Ana Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006704 | Orphan claim re-pointed Claims processor | CLM-426046 → UHC-49200-73 (Roy Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006705 | Orphan claim re-pointed Claims processor | CLM-406116 → UHC-97443-27 (Jacqueline Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006706 | Orphan claim re-pointed Claims processor | CLM-429374 → UHC-79290-49 (Russell Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006707 | Orphan claim re-pointed Claims processor | CLM-404225 → UHC-91449-50 (Christnie Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006708 | Orphan claim re-pointed Claims processor | CLM-405032 → UHC-92637-64 (Christopher Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006709 | Orphan claim re-pointed Claims processor | CLM-410421 → UHC-57823-65 (Adrew Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006710 | Orphan claim re-pointed Claims processor | CLM-415649 → UHC-79616-93 (Arthur Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006711 | Orphan claim re-pointed Claims processor | CLM-431272 → UHC-53720-04 (Margaret Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006712 | Orphan claim re-pointed Claims processor | CLM-416073 → UHC-50102-32 (Elijah Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006713 | Orphan claim re-pointed Claims processor | CLM-406198 → UHC-13605-88 (Christine Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006714 | Orphan claim re-pointed Claims processor | CLM-424564 → UHC-85159-64 (Brandon Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006715 | Orphan claim re-pointed Claims processor | CLM-418224 → UHC-16307-85 (Mariana Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006716 | Orphan claim re-pointed Claims processor | CLM-403161 → UHC-58975-56 (Marcus Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006717 | Orphan claim re-pointed Claims processor | CLM-415570 → UHC-81996-24 (Timothy Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006718 | Orphan claim re-pointed Claims processor | CLM-428616 → UHC-45580-06 (Andrea Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006719 | Orphan claim re-pointed Claims processor | CLM-417795 → UHC-25356-26 (Jacob Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006720 | Orphan claim re-pointed Claims processor | CLM-415853 → UHC-15182-35 (Bryan Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006721 | Orphan claim re-pointed Claims processor | CLM-402963 → UHC-03938-67 (Ryan Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006722 | Orphan claim re-pointed Claims processor | CLM-412437 → UHC-59853-62 (Dorothy Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006723 | Orphan claim re-pointed Claims processor | CLM-416717 → UHC-61947-38 (Jerry Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006724 | Orphan claim re-pointed Claims processor | CLM-406771 → UHC-99532-19 (Russell Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006725 | Orphan claim re-pointed Claims processor | CLM-417370 → UHC-72278-72 (Evelyn Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006726 | Orphan claim re-pointed Claims processor | CLM-416447 → UHC-22887-94 (Charlotte Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006727 | Orphan claim re-pointed Claims processor | CLM-421289 → UHC-68446-58 (Marilyn Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006728 | Orphan claim re-pointed Claims processor | CLM-425761 → UHC-96628-55 (Elizabeth Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006729 | Orphan claim re-pointed Claims processor | CLM-411764 → UHC-47202-94 (Joe Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006730 | Orphan claim re-pointed Claims processor | CLM-405401 → UHC-49684-67 (Carolyn Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006731 | Orphan claim re-pointed Claims processor | CLM-432053 → UHC-21830-24 (Abigail Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006732 | Orphan claim re-pointed Claims processor | CLM-416354 → UHC-32256-98 (Bruce Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006733 | Orphan claim re-pointed Claims processor | CLM-408096 → UHC-05118-85 (Eugene Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006734 | Orphan claim re-pointed Claims processor | CLM-431859 → UHC-62190-94 (Randy Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006735 | Orphan claim re-pointed Claims processor | CLM-421055 → UHC-98893-34 (Dennis Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006736 | Orphan claim re-pointed Claims processor | CLM-413508 → UHC-20821-83 (Joyce Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006737 | Orphan claim re-pointed Claims processor | CLM-400059 → UHC-69691-36 (Jeremy Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006738 | Orphan claim re-pointed Claims processor | CLM-426801 → UHC-29982-74 (Judy Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006739 | Orphan claim re-pointed Claims processor | CLM-411705 → UHC-78345-09 (Ryan Riley) |
| 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.