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-007690 | Orphan claim re-pointed Claims processor | CLM-422735 → UHC-51537-03 (Roger Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007691 | Orphan claim re-pointed Claims processor | CLM-431557 → UHC-06184-67 (Yuki Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007692 | Orphan claim re-pointed Claims processor | CLM-427842 → UHC-62350-39 (Jack Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007693 | Orphan claim re-pointed Claims processor | CLM-407758 → UHC-30615-60 (Daniel Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007694 | Orphan claim re-pointed Claims processor | CLM-400906 → UHC-75549-63 (Adam Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007695 | Orphan claim re-pointed Claims processor | CLM-421406 → UHC-26837-69 (Aisha Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007696 | Orphan claim re-pointed Claims processor | CLM-403887 → UHC-15892-86 (Gabriel Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007697 | Orphan claim re-pointed Claims processor | CLM-426838 → UHC-56314-20 (Carolyn Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007698 | Orphan claim re-pointed Claims processor | CLM-417897 → UHC-65661-98 (Brian Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007699 | Orphan claim re-pointed Claims processor | CLM-403458 → UHC-07604-11 (Samuel Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007700 | Orphan claim re-pointed Claims processor | CLM-410855 → UHC-47698-99 (Katherine Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007701 | Orphan claim re-pointed Claims processor | CLM-409408 → UHC-98890-36 (Mason Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007702 | Orphan claim re-pointed Claims processor | CLM-404958 → UHC-22808-33 (Raachel Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007703 | Orphan claim re-pointed Claims processor | CLM-431096 → UHC-84529-42 (Karen Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007704 | Orphan claim re-pointed Claims processor | CLM-430440 → UHC-60914-75 (Gerald Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007705 | Orphan claim re-pointed Claims processor | CLM-404226 → UHC-92454-63 (Marcus Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007706 | Orphan claim re-pointed Claims processor | CLM-419743 → UHC-10969-44 (Christina Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007707 | Orphan claim re-pointed Claims processor | CLM-409462 → UHC-02296-66 (Jerry Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007708 | Orphan claim re-pointed Claims processor | CLM-431331 → UHC-37861-98 (Logan Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007709 | Orphan claim re-pointed Claims processor | CLM-409495 → UHC-18051-11 (Justin Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007710 | Orphan claim re-pointed Claims processor | CLM-426865 → UHC-57023-24 (Brandon Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007711 | Orphan claim re-pointed Claims processor | CLM-402807 → UHC-29388-20 (Joyce Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007712 | Orphan claim re-pointed Claims processor | CLM-414316 → UHC-59431-11 (Carolyn Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007713 | Orphan claim re-pointed Claims processor | CLM-402294 → UHC-84577-80 (Julie Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007714 | Orphan claim re-pointed Claims processor | CLM-431945 → UHC-47195-70 (Diane Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007715 | Orphan claim re-pointed Claims processor | CLM-412219 → UHC-67757-69 (Ahmed Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007716 | Orphan claim re-pointed Claims processor | CLM-406800 → UHC-72508-09 (Teresa Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007717 | Orphan claim re-pointed Claims processor | CLM-422993 → UHC-79259-25 (Betty Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007718 | Orphan claim re-pointed Claims processor | CLM-429255 → UHC-86504-87 (Mei Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007719 | Orphan claim re-pointed Claims processor | CLM-427799 → UHC-31711-68 (Jason Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007720 | Orphan claim re-pointed Claims processor | CLM-405564 → UHC-76339-06 (Jack Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007721 | Orphan claim re-pointed Claims processor | CLM-400697 → UHC-94092-96 (Yuki Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007722 | Orphan claim re-pointed Claims processor | CLM-409952 → UHC-55063-31 (Douglas Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007723 | Orphan claim re-pointed Claims processor | CLM-405263 → UHC-17023-89 (Judith Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007724 | Orphan claim re-pointed Claims processor | CLM-420056 → UHC-71570-03 (Robert Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007725 | Orphan claim re-pointed Claims processor | CLM-411082 → UHC-73884-55 (Gabriel Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007726 | Orphan claim re-pointed Claims processor | CLM-426799 → UHC-13697-19 (Scott Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007727 | Orphan claim re-pointed Claims processor | CLM-410055 → UHC-68288-17 (Emma Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007728 | Orphan claim re-pointed Claims processor | CLM-423792 → UHC-42367-19 (Saamntha Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007729 | Orphan claim re-pointed Claims processor | CLM-412914 → UHC-78353-92 (Margaret Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007730 | Orphan claim re-pointed Claims processor | CLM-415671 → UHC-43243-09 (Karen Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007731 | Orphan claim re-pointed Claims processor | CLM-411748 → UHC-80429-86 (Seaan Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007732 | Orphan claim re-pointed Claims processor | CLM-419630 → UHC-44088-21 (Diego Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007733 | Orphan claim re-pointed Claims processor | CLM-422285 → UHC-51601-85 (Maria Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007734 | Orphan claim re-pointed Claims processor | CLM-425568 → UHC-72694-61 (Peter Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007735 | Orphan claim re-pointed Claims processor | CLM-419298 → UHC-12076-16 (Isabella Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007736 | Orphan claim re-pointed Claims processor | CLM-425776 → UHC-19163-11 (Karen Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007737 | Orphan claim re-pointed Claims processor | CLM-408916 → UHC-61611-95 (Peter Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007738 | Orphan claim re-pointed Claims processor | CLM-425968 → UHC-84938-93 (Sophia Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007739 | Orphan claim re-pointed Claims processor | CLM-424563 → UHC-27034-47 (Bruce Burke) |
| 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.