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-008140 | Orphan claim re-pointed Claims processor | CLM-423877 → UHC-01003-36 (Joshua Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008141 | Orphan claim re-pointed Claims processor | CLM-428303 → UHC-42987-12 (Brittany Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008142 | Orphan claim re-pointed Claims processor | CLM-410420 → UHC-92906-33 (Sara Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008143 | Orphan claim re-pointed Claims processor | CLM-408625 → UHC-26618-68 (Betty Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008144 | Orphan claim re-pointed Claims processor | CLM-415804 → UHC-94480-70 (Mary Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008145 | Orphan claim re-pointed Claims processor | CLM-420167 → UHC-88779-73 (Sue Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008146 | Orphan claim re-pointed Claims processor | CLM-420230 → UHC-78016-26 (Lawrence Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008147 | Orphan claim re-pointed Claims processor | CLM-421985 → UHC-15116-96 (Jesse Balck) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008148 | Orphan claim re-pointed Claims processor | CLM-405355 → UHC-77760-37 (Sophia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008149 | Orphan claim re-pointed Claims processor | CLM-400468 → UHC-43822-84 (Virginia Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008150 | Orphan claim re-pointed Claims processor | CLM-424657 → UHC-91228-72 (Frank Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008151 | Orphan claim re-pointed Claims processor | CLM-430211 → UHC-63930-87 (Alan Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008152 | Orphan claim re-pointed Claims processor | CLM-426481 → UHC-87593-18 (Teresa Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008153 | Orphan claim re-pointed Claims processor | CLM-428833 → UHC-76258-52 (Roger Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008154 | Orphan claim re-pointed Claims processor | CLM-426674 → UHC-30099-24 (Carlos Sttewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008155 | Orphan claim re-pointed Claims processor | CLM-428398 → UHC-37392-76 (Heather Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008156 | Orphan claim re-pointed Claims processor | CLM-415470 → UHC-23648-90 (Natalie Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008157 | Orphan claim re-pointed Claims processor | CLM-408356 → UHC-50549-37 (Camila Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008158 | Orphan claim re-pointed Claims processor | CLM-422897 → UHC-11424-61 (Jean Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008159 | Orphan claim re-pointed Claims processor | CLM-428843 → UHC-67988-31 (Peter Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008160 | Orphan claim re-pointed Claims processor | CLM-429189 → UHC-54998-45 (Sara Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008161 | Orphan claim re-pointed Claims processor | CLM-423403 → UHC-41069-52 (Carolyn Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008162 | Orphan claim re-pointed Claims processor | CLM-417875 → UHC-13108-98 (Madison Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008163 | Orphan claim re-pointed Claims processor | CLM-424744 → UHC-06546-55 (Christine Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008164 | Orphan claim re-pointed Claims processor | CLM-420522 → UHC-34094-33 (Judith Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008165 | Orphan claim re-pointed Claims processor | CLM-413644 → UHC-71517-82 (Lauren Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008166 | Orphan claim re-pointed Claims processor | CLM-407633 → UHC-51627-22 (Gregory Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008167 | Orphan claim re-pointed Claims processor | CLM-406519 → UHC-19783-34 (Linda Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008168 | Orphan claim re-pointed Claims processor | CLM-421708 → UHC-09615-90 (Lauren Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008169 | Orphan claim re-pointed Claims processor | CLM-402941 → UHC-20249-57 (Patrick McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008170 | Orphan claim re-pointed Claims processor | CLM-420887 → UHC-40188-10 (Diana Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008171 | Orphan claim re-pointed Claims processor | CLM-416563 → UHC-50426-10 (Margaret Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008172 | Orphan claim re-pointed Claims processor | CLM-414218 → UHC-20492-19 (Andrew Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008173 | Orphan claim re-pointed Claims processor | CLM-411317 → UHC-59588-79 (Betty Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008174 | Orphan claim re-pointed Claims processor | CLM-407737 → UHC-00389-04 (Betty Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008175 | Orphan claim re-pointed Claims processor | CLM-405200 → UHC-39326-26 (Amy Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008176 | Orphan claim re-pointed Claims processor | CLM-426756 → UHC-51903-21 (Debra Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008177 | Orphan claim re-pointed Claims processor | CLM-401347 → UHC-17441-60 (Rebecca Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008178 | Orphan claim re-pointed Claims processor | CLM-415407 → UHC-58083-73 (Jean Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008179 | Orphan claim re-pointed Claims processor | CLM-432369 → UHC-01660-56 (Brandon Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008180 | Orphan claim re-pointed Claims processor | CLM-400497 → UHC-65932-60 (Judith Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008181 | Orphan claim re-pointed Claims processor | CLM-431881 → UHC-48820-35 (Gloria Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008182 | Orphan claim re-pointed Claims processor | CLM-410840 → UHC-11699-14 (Amy Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008183 | Orphan claim re-pointed Claims processor | CLM-406443 → UHC-43328-08 (Abby Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008184 | Orphan claim re-pointed Claims processor | CLM-426050 → UHC-61080-99 (Sarah Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008185 | Orphan claim re-pointed Claims processor | CLM-415758 → UHC-55567-38 (Michael Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008186 | Orphan claim re-pointed Claims processor | CLM-401987 → UHC-29928-29 (Stephen Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008187 | Orphan claim re-pointed Claims processor | CLM-420366 → UHC-82931-02 (Kayla Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008188 | Orphan claim re-pointed Claims processor | CLM-424174 → UHC-90955-10 (Doris Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008189 | Orphan claim re-pointed Claims processor | CLM-414138 → UHC-72994-01 (Raymond Banks) |
| 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.