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-006940 | Orphan claim re-pointed Claims processor | CLM-427700 → UHC-33223-95 (Katherine West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006941 | Orphan claim re-pointed Claims processor | CLM-417326 → UHC-89739-33 (Dennis Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006942 | Orphan claim re-pointed Claims processor | CLM-417348 → UHC-62307-74 (Lawrence Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006943 | Orphan claim re-pointed Claims processor | CLM-405121 → UHC-60419-18 (Steven Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006944 | Orphan claim re-pointed Claims processor | CLM-412066 → UHC-79382-41 (Ruth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006945 | Orphan claim re-pointed Claims processor | CLM-420796 → UHC-91720-52 (Aaron Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006946 | Orphan claim re-pointed Claims processor | CLM-402045 → UHC-95997-72 (Brian Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006947 | Orphan claim re-pointed Claims processor | CLM-404487 → UHC-64676-94 (Mason Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006948 | Orphan claim re-pointed Claims processor | CLM-411856 → UHC-29394-99 (Jason Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006949 | Orphan claim re-pointed Claims processor | CLM-415424 → UHC-21736-01 (Ahmed Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006950 | Orphan claim re-pointed Claims processor | CLM-432180 → UHC-18459-11 (Doris Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006951 | Orphan claim re-pointed Claims processor | CLM-414924 → UHC-51151-71 (Gabriel Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006952 | Orphan claim re-pointed Claims processor | CLM-402882 → UHC-00099-58 (Gloria Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006953 | Orphan claim re-pointed Claims processor | CLM-431057 → UHC-10098-84 (Ashley Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006954 | Orphan claim re-pointed Claims processor | CLM-432508 → UHC-81285-76 (Kevin Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006955 | Orphan claim re-pointed Claims processor | CLM-419280 → UHC-71262-56 (Austin Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006956 | Orphan claim re-pointed Claims processor | CLM-431830 → UHC-09549-19 (Russell Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006957 | Orphan claim re-pointed Claims processor | CLM-412335 → UHC-29479-71 (Stephen Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006958 | Orphan claim re-pointed Claims processor | CLM-421149 → UHC-31075-42 (Matthew Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006959 | Orphan claim re-pointed Claims processor | CLM-427029 → UHC-89619-29 (Doris Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006960 | Orphan claim re-pointed Claims processor | CLM-419609 → UHC-09077-92 (Isabella Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006961 | Orphan claim re-pointed Claims processor | CLM-404857 → UHC-20418-29 (Arthur Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006962 | Orphan claim re-pointed Claims processor | CLM-405521 → UHC-19959-40 (Priya Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006963 | Orphan claim re-pointed Claims processor | CLM-431816 → UHC-08988-90 (Camila Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006964 | Orphan claim re-pointed Claims processor | CLM-409207 → UHC-33869-68 (Jonathan Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006965 | Orphan claim re-pointed Claims processor | CLM-417622 → UHC-02623-23 (Austin Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006966 | Orphan claim re-pointed Claims processor | CLM-405720 → UHC-12590-72 (Mary Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006967 | Orphan claim re-pointed Claims processor | CLM-417295 → UHC-06610-34 (Brittany Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006968 | Orphan claim re-pointed Claims processor | CLM-401762 → UHC-44925-24 (Bradley Gilbet) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006969 | Orphan claim re-pointed Claims processor | CLM-414329 → UHC-75183-23 (Bobby Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006970 | Orphan claim re-pointed Claims processor | CLM-419407 → UHC-41975-39 (Mary Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006971 | Orphan claim re-pointed Claims processor | CLM-425068 → UHC-52069-26 (Eric Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006972 | Orphan claim re-pointed Claims processor | CLM-430851 → UHC-97369-50 (Gabriel Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006973 | Orphan claim re-pointed Claims processor | CLM-411977 → UHC-40282-62 (Frank Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006974 | Orphan claim re-pointed Claims processor | CLM-424476 → UHC-55479-79 (Diana Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006975 | Orphan claim re-pointed Claims processor | CLM-422895 → UHC-46475-46 (Austin Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006976 | Orphan claim re-pointed Claims processor | CLM-417743 → UHC-87202-79 (Bryan Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006977 | Orphan claim re-pointed Claims processor | CLM-403389 → UHC-33506-03 (Brian Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006978 | Orphan claim re-pointed Claims processor | CLM-431069 → UHC-27450-46 (Kayla Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006979 | Orphan claim re-pointed Claims processor | CLM-428874 → UHC-37584-31 (Jean Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006980 | Orphan claim re-pointed Claims processor | CLM-413322 → UHC-06114-93 (Nancy Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006981 | Orphan claim re-pointed Claims processor | CLM-419688 → UHC-57924-23 (Ryan Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006982 | Orphan claim re-pointed Claims processor | CLM-424968 → UHC-21100-34 (Joseph Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006983 | Orphan claim re-pointed Claims processor | CLM-408489 → UHC-54352-44 (Madison Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006984 | Orphan claim re-pointed Claims processor | CLM-410792 → UHC-40739-50 (Julie Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006985 | Orphan claim re-pointed Claims processor | CLM-413119 → UHC-69924-78 (Yuki Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006986 | Orphan claim re-pointed Claims processor | CLM-424111 → UHC-73006-67 (Doris Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006987 | Orphan claim re-pointed Claims processor | CLM-426353 → UHC-51163-84 (Maria Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006988 | Orphan claim re-pointed Claims processor | CLM-418278 → UHC-08748-12 (Robetr Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006989 | Orphan claim re-pointed Claims processor | CLM-404408 → UHC-78331-45 (Matthew White) |
| 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.