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-007590 | Orphan claim re-pointed Claims processor | CLM-414326 → UHC-85826-69 (Luis Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007591 | Orphan claim re-pointed Claims processor | CLM-427971 → UHC-89444-27 (Hannah Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007592 | Orphan claim re-pointed Claims processor | CLM-419692 → UHC-17184-54 (Jeremy Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007593 | Orphan claim re-pointed Claims processor | CLM-410030 → UHC-19618-72 (William Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007594 | Orphan claim re-pointed Claims processor | CLM-410066 → UHC-20345-09 (Martha Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007595 | Orphan claim re-pointed Claims processor | CLM-421760 → UHC-97057-97 (Isabella Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007596 | Orphan claim re-pointed Claims processor | CLM-412950 → UHC-69693-06 (David Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007597 | Orphan claim re-pointed Claims processor | CLM-416980 → UHC-19530-96 (Sarah Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007598 | Orphan claim re-pointed Claims processor | CLM-423632 → UHC-00515-59 (Ryan Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007599 | Orphan claim re-pointed Claims processor | CLM-409312 → UHC-16964-87 (Douglas Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007600 | Orphan claim re-pointed Claims processor | CLM-415220 → UHC-04124-95 (Lawrence Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007601 | Orphan claim re-pointed Claims processor | CLM-404906 → UHC-57453-80 (Nancy Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007602 | Orphan claim re-pointed Claims processor | CLM-424333 → UHC-81293-58 (Sofia Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007603 | Orphan claim re-pointed Claims processor | CLM-428940 → UHC-10473-09 (Victoria Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007604 | Orphan claim re-pointed Claims processor | CLM-406612 → UHC-87595-03 (Joseph Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007605 | Orphan claim re-pointed Claims processor | CLM-407377 → UHC-56836-11 (Joe Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007606 | Orphan claim re-pointed Claims processor | CLM-405459 → UHC-61727-63 (Denise Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007607 | Orphan claim re-pointed Claims processor | CLM-429127 → UHC-76656-69 (Lauren Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007608 | Orphan claim re-pointed Claims processor | CLM-404389 → UHC-03319-04 (Deniise Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007609 | Orphan claim re-pointed Claims processor | CLM-426470 → UHC-81117-27 (Bobby Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007610 | Orphan claim re-pointed Claims processor | CLM-410869 → UHC-57895-27 (Frank Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007611 | Orphan claim re-pointed Claims processor | CLM-426654 → UHC-70640-04 (Joseph Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007612 | Orphan claim re-pointed Claims processor | CLM-426554 → UHC-10433-05 (Mason Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007613 | Orphan claim re-pointed Claims processor | CLM-410785 → UHC-41901-62 (Justin Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007614 | Orphan claim re-pointed Claims processor | CLM-417269 → UHC-57936-14 (Elijah Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007615 | Orphan claim re-pointed Claims processor | CLM-428510 → UHC-55442-75 (Frank Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007616 | Orphan claim re-pointed Claims processor | CLM-425314 → UHC-76683-43 (Ralph Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007617 | Orphan claim re-pointed Claims processor | CLM-405939 → UHC-49348-09 (Frances Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007618 | Orphan claim re-pointed Claims processor | CLM-419374 → UHC-74318-39 (Christine Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007619 | Orphan claim re-pointed Claims processor | CLM-429838 → UHC-19337-80 (Rachel Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007620 | Orphan claim re-pointed Claims processor | CLM-416483 → UHC-72382-09 (Arthur Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007621 | Orphan claim re-pointed Claims processor | CLM-420920 → UHC-93293-77 (Elijah Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007622 | Orphan claim re-pointed Claims processor | CLM-404929 → UHC-33686-75 (Josuha Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007623 | Orphan claim re-pointed Claims processor | CLM-421373 → UHC-79512-87 (Frances Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007624 | Orphan claim re-pointed Claims processor | CLM-402251 → UHC-28664-92 (Nancy Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007625 | Orphan claim re-pointed Claims processor | CLM-424179 → UHC-06849-83 (Joe Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007626 | Orphan claim re-pointed Claims processor | CLM-428542 → UHC-46195-40 (John Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007627 | Orphan claim re-pointed Claims processor | CLM-429811 → UHC-48838-44 (Elizabeth Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007628 | Orphan claim re-pointed Claims processor | CLM-420769 → UHC-65006-18 (Danielle Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007629 | Orphan claim re-pointed Claims processor | CLM-417129 → UHC-94499-61 (Diego Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007630 | Orphan claim re-pointed Claims processor | CLM-410481 → UHC-70616-98 (Ronald Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007631 | Orphan claim re-pointed Claims processor | CLM-404375 → UHC-14825-01 (Billy Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007632 | Orphan claim re-pointed Claims processor | CLM-419089 → UHC-03947-55 (Theresa Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007633 | Orphan claim re-pointed Claims processor | CLM-404572 → UHC-63932-33 (Susan Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007634 | Orphan claim re-pointed Claims processor | CLM-416887 → UHC-35049-87 (Jerry Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007635 | Orphan claim re-pointed Claims processor | CLM-420415 → UHC-85070-52 (Camila Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007636 | Orphan claim re-pointed Claims processor | CLM-401101 → UHC-70306-47 (Hannah Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007637 | Orphan claim re-pointed Claims processor | CLM-425022 → UHC-98289-93 (Austin Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007638 | Orphan claim re-pointed Claims processor | CLM-417826 → UHC-66935-98 (Ashley Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007639 | Orphan claim re-pointed Claims processor | CLM-431898 → UHC-38371-52 (Margaret Fernandez) |
| 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.