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-007490 | Orphan claim re-pointed Claims processor | CLM-426621 → UHC-33731-33 (Charlotte Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007491 | Orphan claim re-pointed Claims processor | CLM-419118 → UHC-40864-53 (Gary Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007492 | Orphan claim re-pointed Claims processor | CLM-432155 → UHC-76846-41 (Kelly Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007493 | Orphan claim re-pointed Claims processor | CLM-431739 → UHC-18114-77 (Arthur Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007494 | Orphan claim re-pointed Claims processor | CLM-428839 → UHC-53711-81 (Samantha Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007495 | Orphan claim re-pointed Claims processor | CLM-423114 → UHC-29521-60 (Jonathan Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007496 | Orphan claim re-pointed Claims processor | CLM-401915 → UHC-01025-68 (Sharon Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007497 | Orphan claim re-pointed Claims processor | CLM-421259 → UHC-61130-89 (Dorothy Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007498 | Orphan claim re-pointed Claims processor | CLM-414798 → UHC-81288-01 (Billy Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007499 | Orphan claim re-pointed Claims processor | CLM-402918 → UHC-34706-33 (Roy Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007500 | Orphan claim re-pointed Claims processor | CLM-419835 → UHC-11708-31 (Albert Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007501 | Orphan claim re-pointed Claims processor | CLM-420161 → UHC-62276-24 (Abigail Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007502 | Orphan claim re-pointed Claims processor | CLM-421846 → UHC-03091-21 (Martha Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007503 | Orphan claim re-pointed Claims processor | CLM-407782 → UHC-93997-42 (Mark Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007504 | Orphan claim re-pointed Claims processor | CLM-402266 → UHC-87849-68 (Camila Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007505 | Orphan claim re-pointed Claims processor | CLM-415081 → UHC-76216-09 (James Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007506 | Orphan claim re-pointed Claims processor | CLM-426074 → UHC-88538-10 (Emily Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007507 | Orphan claim re-pointed Claims processor | CLM-414331 → UHC-83189-38 (Linda Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007508 | Orphan claim re-pointed Claims processor | CLM-402555 → UHC-52868-26 (Bruce Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007509 | Orphan claim re-pointed Claims processor | CLM-415418 → UHC-70723-03 (Keith Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007510 | Orphan claim re-pointed Claims processor | CLM-421139 → UHC-20503-28 (Arthur Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007511 | Orphan claim re-pointed Claims processor | CLM-410675 → UHC-71292-65 (Billy Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007512 | Orphan claim re-pointed Claims processor | CLM-420990 → UHC-72496-83 (Heather Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007513 | Orphan claim re-pointed Claims processor | CLM-418561 → UHC-91227-85 (Stephen Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007514 | Orphan claim re-pointed Claims processor | CLM-420457 → UHC-71644-84 (Samantha Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007515 | Orphan claim re-pointed Claims processor | CLM-406789 → UHC-12444-24 (Diana James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007516 | Orphan claim re-pointed Claims processor | CLM-430887 → UHC-30278-64 (George Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007517 | Orphan claim re-pointed Claims processor | CLM-428414 → UHC-65934-13 (Nicholas Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007518 | Orphan claim re-pointed Claims processor | CLM-403378 → UHC-90646-48 (Roy Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007519 | Orphan claim re-pointed Claims processor | CLM-422765 → UHC-49598-70 (Andrea Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007520 | Orphan claim re-pointed Claims processor | CLM-432553 → UHC-54469-23 (Camila Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007521 | Orphan claim re-pointed Claims processor | CLM-421172 → UHC-61674-63 (Joyce Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007522 | Orphan claim re-pointed Claims processor | CLM-431063 → UHC-74905-30 (Carolyn Sotto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007523 | Orphan claim re-pointed Claims processor | CLM-422401 → UHC-06772-04 (Sharon Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007524 | Orphan claim re-pointed Claims processor | CLM-430782 → UHC-48702-23 (Catherine Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007525 | Orphan claim re-pointed Claims processor | CLM-404155 → UHC-47212-39 (Olivia Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007526 | Orphan claim re-pointed Claims processor | CLM-420321 → UHC-80809-16 (Isabella Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007527 | Orphan claim re-pointed Claims processor | CLM-401465 → UHC-10719-99 (Barbara Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007528 | Orphan claim re-pointed Claims processor | CLM-425036 → UHC-89357-17 (Brittany Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007529 | Orphan claim re-pointed Claims processor | CLM-407395 → UHC-82109-72 (Madison Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007530 | Orphan claim re-pointed Claims processor | CLM-426774 → UHC-33663-44 (Bradley Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007531 | Orphan claim re-pointed Claims processor | CLM-408460 → UHC-01984-24 (Brenda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007532 | Orphan claim re-pointed Claims processor | CLM-420892 → UHC-34115-12 (Benjamin Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007533 | Orphan claim re-pointed Claims processor | CLM-431795 → UHC-48995-75 (Amber Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007534 | Orphan claim re-pointed Claims processor | CLM-421896 → UHC-62313-89 (Ethan Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007535 | Orphan claim re-pointed Claims processor | CLM-424810 → UHC-11944-53 (Charles Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007536 | Orphan claim re-pointed Claims processor | CLM-417328 → UHC-18243-61 (Michael Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007537 | Orphan claim re-pointed Claims processor | CLM-426339 → UHC-90493-22 (Eugene Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007538 | Orphan claim re-pointed Claims processor | CLM-410042 → UHC-00360-38 (Sharon Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007539 | Orphan claim re-pointed Claims processor | CLM-420953 → UHC-28875-07 (Hiroshi Montgomery) |
| 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.