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-007790 | Orphan claim re-pointed Claims processor | CLM-429620 → UHC-66748-29 (Robert Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007791 | Orphan claim re-pointed Claims processor | CLM-401492 → UHC-06635-80 (Bruce Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007792 | Orphan claim re-pointed Claims processor | CLM-408068 → UHC-79113-04 (Mary Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007793 | Orphan claim re-pointed Claims processor | CLM-408995 → UHC-49588-49 (Alan Buke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007794 | Orphan claim re-pointed Claims processor | CLM-430160 → UHC-26988-86 (Yuki Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007795 | Orphan claim re-pointed Claims processor | CLM-429780 → UHC-69402-86 (Stephen Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007796 | Orphan claim re-pointed Claims processor | CLM-431546 → UHC-60838-89 (Christian Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007797 | Orphan claim re-pointed Claims processor | CLM-425882 → UHC-85627-10 (Robert Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007798 | Orphan claim re-pointed Claims processor | CLM-400291 → UHC-30695-21 (Brian Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007799 | Orphan claim re-pointed Claims processor | CLM-419339 → UHC-85345-13 (Fatima Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007800 | Orphan claim re-pointed Claims processor | CLM-409166 → UHC-80089-58 (Juan Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007801 | Orphan claim re-pointed Claims processor | CLM-407010 → UHC-36481-22 (Ethan Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007802 | Orphan claim re-pointed Claims processor | CLM-416787 → UHC-34296-72 (George Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007803 | Orphan claim re-pointed Claims processor | CLM-402360 → UHC-31543-99 (Wayne McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007804 | Orphan claim re-pointed Claims processor | CLM-406404 → UHC-39935-89 (Marcus Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007805 | Orphan claim re-pointed Claims processor | CLM-415855 → UHC-20229-05 (Debra Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007806 | Orphan claim re-pointed Claims processor | CLM-404142 → UHC-00259-16 (Betty Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007807 | Orphan claim re-pointed Claims processor | CLM-420188 → UHC-80890-25 (George Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007808 | Orphan claim re-pointed Claims processor | CLM-400705 → UHC-36383-41 (Brian Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007809 | Orphan claim re-pointed Claims processor | CLM-406710 → UHC-37203-81 (Marianna Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007810 | Orphan claim re-pointed Claims processor | CLM-411533 → UHC-11070-99 (Logan Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007811 | Orphan claim re-pointed Claims processor | CLM-426823 → UHC-66444-97 (Jerry Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007812 | Orphan claim re-pointed Claims processor | CLM-432387 → UHC-40021-88 (Margaret Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007813 | Orphan claim re-pointed Claims processor | CLM-422110 → UHC-09967-78 (Emily Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007814 | Orphan claim re-pointed Claims processor | CLM-418844 → UHC-84212-31 (David Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007815 | Orphan claim re-pointed Claims processor | CLM-403802 → UHC-30857-34 (Frances Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007816 | Orphan claim re-pointed Claims processor | CLM-412680 → UHC-72442-85 (Billy Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007817 | Orphan claim re-pointed Claims processor | CLM-412179 → UHC-70243-81 (Julie Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007818 | Orphan claim re-pointed Claims processor | CLM-401666 → UHC-27598-23 (Emma Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007819 | Orphan claim re-pointed Claims processor | CLM-405420 → UHC-45453-34 (Maria Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007820 | Orphan claim re-pointed Claims processor | CLM-407218 → UHC-78541-97 (Bobby Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007821 | Orphan claim re-pointed Claims processor | CLM-414631 → UHC-31118-91 (Betty Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007822 | Orphan claim re-pointed Claims processor | CLM-424075 → UHC-65631-51 (Ralph Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007823 | Orphan claim re-pointed Claims processor | CLM-422231 → UHC-49624-39 (Hiroshi Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007824 | Orphan claim re-pointed Claims processor | CLM-409578 → UHC-88223-20 (Luis Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007825 | Orphan claim re-pointed Claims processor | CLM-408487 → UHC-60615-04 (Austin Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007826 | Orphan claim re-pointed Claims processor | CLM-410817 → UHC-19980-14 (Stephen Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007827 | Orphan claim re-pointed Claims processor | CLM-408412 → UHC-53467-07 (Bobby Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007828 | Orphan claim re-pointed Claims processor | CLM-424512 → UHC-62449-29 (Justin Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007829 | Orphan claim re-pointed Claims processor | CLM-430537 → UHC-86464-10 (Alexis Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007830 | Orphan claim re-pointed Claims processor | CLM-400294 → UHC-16705-36 (Valentina Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007831 | Orphan claim re-pointed Claims processor | CLM-429273 → UHC-52708-61 (Madison Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007832 | Orphan claim re-pointed Claims processor | CLM-408982 → UHC-84014-04 (Joan Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007833 | Orphan claim re-pointed Claims processor | CLM-427841 → UHC-62019-85 (Eirc Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007834 | Orphan claim re-pointed Claims processor | CLM-426712 → UHC-56407-99 (Teresa Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007835 | Orphan claim re-pointed Claims processor | CLM-417450 → UHC-03925-28 (Kenneth Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007836 | Orphan claim re-pointed Claims processor | CLM-402782 → UHC-58954-87 (Wei Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007837 | Orphan claim re-pointed Claims processor | CLM-403640 → UHC-11908-79 (Dorothy Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007838 | Orphan claim re-pointed Claims processor | CLM-412441 → UHC-68781-22 (Timothy Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007839 | Orphan claim re-pointed Claims processor | CLM-401791 → UHC-38852-43 (Walter Harris) |
| 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.