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-006790 | Orphan claim re-pointed Claims processor | CLM-411244 → UHC-67679-87 (Henry Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006791 | Orphan claim re-pointed Claims processor | CLM-404219 → UHC-42564-49 (Joseph Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006792 | Orphan claim re-pointed Claims processor | CLM-406361 → UHC-31605-12 (Lawson Michael) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006793 | Orphan claim re-pointed Claims processor | CLM-410470 → UHC-82854-28 (Juan Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006794 | Orphan claim re-pointed Claims processor | CLM-424452 → UHC-50647-01 (Noah Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006795 | Orphan claim re-pointed Claims processor | CLM-421979 → UHC-10502-17 (Grace Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006796 | Orphan claim re-pointed Claims processor | CLM-414608 → UHC-86265-57 (Rachel Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006797 | Orphan claim re-pointed Claims processor | CLM-405145 → UHC-68210-89 (Alexis Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006798 | Orphan claim re-pointed Claims processor | CLM-408712 → UHC-79682-77 (John Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006799 | Orphan claim re-pointed Claims processor | CLM-428098 → UHC-81595-06 (Kathleen Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006800 | Orphan claim re-pointed Claims processor | CLM-431106 → UHC-00981-78 (Sandra Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006801 | Orphan claim re-pointed Claims processor | CLM-413667 → UHC-79675-66 (Stephen Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006802 | Orphan claim re-pointed Claims processor | CLM-408176 → UHC-89048-29 (Robert Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006803 | Orphan claim re-pointed Claims processor | CLM-424709 → UHC-98414-49 (Lauren Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006804 | Orphan claim re-pointed Claims processor | CLM-424733 → UHC-17116-81 (Joseph Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006805 | Orphan claim re-pointed Claims processor | CLM-409796 → UHC-95154-03 (Christian Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006806 | Orphan claim re-pointed Claims processor | CLM-421658 → UHC-39030-53 (Kathleen Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006807 | Orphan claim re-pointed Claims processor | CLM-415789 → UHC-83207-26 (Walter Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006808 | Orphan claim re-pointed Claims processor | CLM-416600 → UHC-68040-19 (Lawrence Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006809 | Orphan claim re-pointed Claims processor | CLM-429322 → UHC-22405-40 (Harold Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006810 | Orphan claim re-pointed Claims processor | CLM-424150 → UHC-50752-94 (Laura Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006811 | Orphan claim re-pointed Claims processor | CLM-425907 → UHC-75274-21 (Julie Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006812 | Orphan claim re-pointed Claims processor | CLM-429629 → UHC-25427-90 (Amber Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006813 | Orphan claim re-pointed Claims processor | CLM-414836 → UHC-07492-11 (Kathleen Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006814 | Orphan claim re-pointed Claims processor | CLM-411678 → UHC-83736-19 (Carolyn Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006815 | Orphan claim re-pointed Claims processor | CLM-427172 → UHC-11439-98 (Bryan Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006816 | Orphan claim re-pointed Claims processor | CLM-414507 → UHC-55764-27 (Wei Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006817 | Orphan claim re-pointed Claims processor | CLM-410475 → UHC-40219-93 (Heather Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006818 | Orphan claim re-pointed Claims processor | CLM-418996 → UHC-65934-35 (Anthony Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006819 | Orphan claim re-pointed Claims processor | CLM-425916 → UHC-64254-45 (Betsy Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006820 | Orphan claim re-pointed Claims processor | CLM-413913 → UHC-21572-47 (Arthur Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006821 | Orphan claim re-pointed Claims processor | CLM-406479 → UHC-31246-46 (Emily Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006822 | Orphan claim re-pointed Claims processor | CLM-415371 → UHC-39357-75 (Michelle Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006823 | Orphan claim re-pointed Claims processor | CLM-420015 → UHC-17911-64 (Terry Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006824 | Orphan claim re-pointed Claims processor | CLM-417371 → UHC-31720-28 (Ahmed Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006825 | Orphan claim re-pointed Claims processor | CLM-416039 → UHC-55249-21 (Eugene Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006826 | Orphan claim re-pointed Claims processor | CLM-427577 → UHC-57280-21 (Marcus Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006827 | Orphan claim re-pointed Claims processor | CLM-422911 → UHC-54839-19 (Bradley Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006828 | Orphan claim re-pointed Claims processor | CLM-423569 → UHC-06987-44 (Benjamin Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006829 | Orphan claim re-pointed Claims processor | CLM-405349 → UHC-54937-27 (Bryan Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006830 | Orphan claim re-pointed Claims processor | CLM-432376 → UHC-12963-51 (Debra Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006831 | Orphan claim re-pointed Claims processor | CLM-425894 → UHC-20022-73 (Samantha Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006832 | Orphan claim re-pointed Claims processor | CLM-403685 → UHC-66180-38 (Willie Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006833 | Orphan claim re-pointed Claims processor | CLM-410431 → UHC-80895-21 (Katherine Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006834 | Orphan claim re-pointed Claims processor | CLM-428877 → UHC-93061-53 (Kathleen Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006835 | Orphan claim re-pointed Claims processor | CLM-406252 → UHC-88685-49 (Linda Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006836 | Orphan claim re-pointed Claims processor | CLM-407229 → UHC-90026-30 (Bruce Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006837 | Orphan claim re-pointed Claims processor | CLM-432640 → UHC-63949-90 (Sara Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006838 | Orphan claim re-pointed Claims processor | CLM-419657 → UHC-70900-77 (Samuel Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006839 | Orphan claim re-pointed Claims processor | CLM-432472 → UHC-15581-31 (Juan Snyder) |
| 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.