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-007840 | Orphan claim re-pointed Claims processor | CLM-401306 → UHC-76653-03 (Kelly James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007841 | Orphan claim re-pointed Claims processor | CLM-418061 → UHC-48631-14 (Dorothy Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007842 | Orphan claim re-pointed Claims processor | CLM-422279 → UHC-25874-35 (Judith Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007843 | Orphan claim re-pointed Claims processor | CLM-428765 → UHC-27150-81 (Elizabeth Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007844 | Orphan claim re-pointed Claims processor | CLM-413675 → UHC-45287-35 (Carol Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007845 | Orphan claim re-pointed Claims processor | CLM-419090 → UHC-03947-55 (Theresa Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007846 | Orphan claim re-pointed Claims processor | CLM-416404 → UHC-36430-99 (Danielle Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007847 | Orphan claim re-pointed Claims processor | CLM-404376 → UHC-61358-21 (Danielle Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007848 | Orphan claim re-pointed Claims processor | CLM-428412 → UHC-47454-98 (William Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007849 | Orphan claim re-pointed Claims processor | CLM-404238 → UHC-57767-40 (Evelyn Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007850 | Orphan claim re-pointed Claims processor | CLM-432295 → UHC-96578-99 (Aisha Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007851 | Orphan claim re-pointed Claims processor | CLM-403652 → UHC-47113-40 (Christian Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007852 | Orphan claim re-pointed Claims processor | CLM-419571 → UHC-39684-13 (Lisa Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007853 | Orphan claim re-pointed Claims processor | CLM-425082 → UHC-20983-31 (Peter Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007854 | Orphan claim re-pointed Claims processor | CLM-429268 → UHC-74857-31 (Kyle Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007855 | Orphan claim re-pointed Claims processor | CLM-402543 → UHC-03463-23 (Alexis Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007856 | Orphan claim re-pointed Claims processor | CLM-409933 → UHC-42815-90 (Jeffrey Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007857 | Orphan claim re-pointed Claims processor | CLM-415462 → UHC-35281-32 (Frances Roes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007858 | Orphan claim re-pointed Claims processor | CLM-407414 → UHC-50574-79 (Diego Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007859 | Orphan claim re-pointed Claims processor | CLM-400453 → UHC-49635-09 (Amanda Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007860 | Orphan claim re-pointed Claims processor | CLM-430634 → UHC-65543-73 (Alexis Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007861 | Orphan claim re-pointed Claims processor | CLM-403284 → UHC-52805-66 (Judith Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007862 | Orphan claim re-pointed Claims processor | CLM-428533 → UHC-09404-57 (Richard Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007863 | Orphan claim re-pointed Claims processor | CLM-410427 → UHC-83700-12 (Jerry Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007864 | Orphan claim re-pointed Claims processor | CLM-415280 → UHC-85448-95 (Frank Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007865 | Orphan claim re-pointed Claims processor | CLM-430362 → UHC-76562-94 (Janet Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007866 | Orphan claim re-pointed Claims processor | CLM-401803 → UHC-51799-64 (Kayla Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007867 | Orphan claim re-pointed Claims processor | CLM-406101 → UHC-53291-78 (Bobby Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007868 | Orphan claim re-pointed Claims processor | CLM-405665 → UHC-41947-43 (Jacqueline Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007869 | Orphan claim re-pointed Claims processor | CLM-413396 → UHC-47275-39 (Keith Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007870 | Orphan claim re-pointed Claims processor | CLM-404338 → UHC-45612-99 (Jeremy Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007871 | Orphan claim re-pointed Claims processor | CLM-421409 → UHC-26837-69 (Aisha Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007872 | Orphan claim re-pointed Claims processor | CLM-423007 → UHC-12628-50 (John Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007873 | Orphan claim re-pointed Claims processor | CLM-430243 → UHC-44029-86 (Wayne Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007874 | Orphan claim re-pointed Claims processor | CLM-428376 → UHC-97769-98 (David Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007875 | Orphan claim re-pointed Claims processor | CLM-417856 → UHC-90448-89 (Joan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007876 | Orphan claim re-pointed Claims processor | CLM-420416 → UHC-16437-41 (Bruce Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007877 | Orphan claim re-pointed Claims processor | CLM-427175 → UHC-11698-23 (Jennifer Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007878 | Orphan claim re-pointed Claims processor | CLM-419132 → UHC-16999-76 (Camila Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007879 | Orphan claim re-pointed Claims processor | CLM-411263 → UHC-28602-56 (Adam Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007880 | Orphan claim re-pointed Claims processor | CLM-403160 → UHC-48058-63 (Diana Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007881 | Orphan claim re-pointed Claims processor | CLM-431596 → UHC-58263-31 (Grace Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007882 | Orphan claim re-pointed Claims processor | CLM-410967 → UHC-60957-28 (Carolyn Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007883 | Orphan claim re-pointed Claims processor | CLM-407228 → UHC-90026-30 (Bruce Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007884 | Orphan claim re-pointed Claims processor | CLM-430087 → UHC-35018-52 (Amy Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007885 | Orphan claim re-pointed Claims processor | CLM-416393 → UHC-94650-89 (Eric Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007886 | Orphan claim re-pointed Claims processor | CLM-411557 → UHC-99406-56 (Kelly Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007887 | Orphan claim re-pointed Claims processor | CLM-414959 → UHC-10436-45 (Dennis Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007888 | Orphan claim re-pointed Claims processor | CLM-403664 → UHC-72207-33 (Michelle Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007889 | Orphan claim re-pointed Claims processor | CLM-402086 → UHC-03506-46 (Thomas Johnston) |
| 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.