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-006740 | Orphan claim re-pointed Claims processor | CLM-419873 → UHC-06575-07 (Ronald Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006741 | Orphan claim re-pointed Claims processor | CLM-422199 → UHC-87463-27 (Joyce Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006742 | Orphan claim re-pointed Claims processor | CLM-411855 → UHC-97023-90 (Chirstian Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006743 | Orphan claim re-pointed Claims processor | CLM-414192 → UHC-19695-21 (Henry Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006744 | Orphan claim re-pointed Claims processor | CLM-431842 → UHC-72484-78 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006745 | Orphan claim re-pointed Claims processor | CLM-424911 → UHC-60029-27 (Russell Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006746 | Orphan claim re-pointed Claims processor | CLM-400095 → UHC-22998-79 (Cooper Justin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006747 | Orphan claim re-pointed Claims processor | CLM-415986 → UHC-27825-83 (Patrick Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006748 | Orphan claim re-pointed Claims processor | CLM-413627 → UHC-89806-73 (Tyler Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006749 | Orphan claim re-pointed Claims processor | CLM-419601 → UHC-23464-33 (Frances George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006750 | Orphan claim re-pointed Claims processor | CLM-411366 → UHC-56495-72 (Elizabeth Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006751 | Orphan claim re-pointed Claims processor | CLM-426107 → UHC-27206-41 (Rachel Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006752 | Orphan claim re-pointed Claims processor | CLM-423460 → UHC-60980-69 (Kevin Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006753 | Orphan claim re-pointed Claims processor | CLM-422705 → UHC-75540-38 (Virginia Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006754 | Orphan claim re-pointed Claims processor | CLM-405009 → UHC-56192-61 (Richard Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006755 | Orphan claim re-pointed Claims processor | CLM-404937 → UHC-72712-60 (Sara Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006756 | Orphan claim re-pointed Claims processor | CLM-401730 → UHC-13539-41 (Yuki Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006757 | Orphan claim re-pointed Claims processor | CLM-418173 → UHC-53723-54 (Noah Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006758 | Orphan claim re-pointed Claims processor | CLM-416285 → UHC-49851-73 (Mei Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006759 | Orphan claim re-pointed Claims processor | CLM-404928 → UHC-99163-01 (Vincent Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006760 | Orphan claim re-pointed Claims processor | CLM-425734 → UHC-29175-45 (Amber Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006761 | Orphan claim re-pointed Claims processor | CLM-426868 → UHC-65237-74 (Wei Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006762 | Orphan claim re-pointed Claims processor | CLM-426486 → UHC-54492-80 (Jesse Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006763 | Orphan claim re-pointed Claims processor | CLM-420202 → UHC-63561-95 (Alexis Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006764 | Orphan claim re-pointed Claims processor | CLM-424812 → UHC-96827-16 (Daniel Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006765 | Orphan claim re-pointed Claims processor | CLM-401839 → UHC-14204-71 (Hiroshi Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006766 | Orphan claim re-pointed Claims processor | CLM-422578 → UHC-66106-28 (Thomas Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006767 | Orphan claim re-pointed Claims processor | CLM-428153 → UHC-03625-33 (Gloria Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006768 | Orphan claim re-pointed Claims processor | CLM-423234 → UHC-08296-83 (Jeremy Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006769 | Orphan claim re-pointed Claims processor | CLM-428204 → UHC-04373-65 (Andrea Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006770 | Orphan claim re-pointed Claims processor | CLM-418205 → UHC-92780-76 (Sharon Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006771 | Orphan claim re-pointed Claims processor | CLM-414734 → UHC-17061-12 (Shirley Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006772 | Orphan claim re-pointed Claims processor | CLM-425407 → UHC-57765-55 (Kelly Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006773 | Orphan claim re-pointed Claims processor | CLM-418475 → UHC-01651-17 (Ana Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006774 | Orphan claim re-pointed Claims processor | CLM-431267 → UHC-15710-14 (Alice Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006775 | Orphan claim re-pointed Claims processor | CLM-404262 → UHC-18244-83 (Beverly Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006776 | Orphan claim re-pointed Claims processor | CLM-421581 → UHC-19189-76 (Tyler Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006777 | Orphan claim re-pointed Claims processor | CLM-409945 → UHC-04770-46 (Lucia Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006778 | Orphan claim re-pointed Claims processor | CLM-424304 → UHC-83799-46 (Ryan Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006779 | Orphan claim re-pointed Claims processor | CLM-417740 → UHC-66759-58 (Olivia Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006780 | Orphan claim re-pointed Claims processor | CLM-418937 → UHC-17261-98 (Eugene Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006781 | Orphan claim re-pointed Claims processor | CLM-404712 → UHC-84483-96 (Mary Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006782 | Orphan claim re-pointed Claims processor | CLM-423035 → UHC-45067-31 (Camila Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006783 | Orphan claim re-pointed Claims processor | CLM-417817 → UHC-39422-02 (Amy Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006784 | Orphan claim re-pointed Claims processor | CLM-416443 → UHC-65456-50 (Janice Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006785 | Orphan claim re-pointed Claims processor | CLM-426716 → UHC-21038-92 (Melissa Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006786 | Orphan claim re-pointed Claims processor | CLM-417018 → UHC-62623-61 (Jean Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006787 | Orphan claim re-pointed Claims processor | CLM-430940 → UHC-64949-34 (Michelle Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006788 | Orphan claim re-pointed Claims processor | CLM-427198 → UHC-41359-99 (Olivia Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006789 | Orphan claim re-pointed Claims processor | CLM-416288 → UHC-98234-91 (Bryan Gonzales) |
| 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.