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-008290 | Orphan claim re-pointed Claims processor | CLM-429832 → UHC-25390-99 (Jesse Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008291 | Orphan claim re-pointed Claims processor | CLM-424529 → UHC-88160-82 (Elijah Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008292 | Orphan claim re-pointed Claims processor | CLM-403835 → UHC-99304-17 (Frank Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008293 | Orphan claim re-pointed Claims processor | CLM-432466 → UHC-22050-94 (Donald Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008294 | Orphan claim re-pointed Claims processor | CLM-404981 → UHC-89911-60 (Linda Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008295 | Orphan claim re-pointed Claims processor | CLM-409662 → UHC-40928-42 (Santiago Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008296 | Orphan claim re-pointed Claims processor | CLM-402466 → UHC-40777-06 (Alexis Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008297 | Orphan claim re-pointed Claims processor | CLM-406868 → UHC-61614-40 (Virginia Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008298 | Orphan claim re-pointed Claims processor | CLM-406578 → UHC-77689-43 (Abigail Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008299 | Orphan claim re-pointed Claims processor | CLM-424937 → UHC-86507-79 (Wayne Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008300 | Orphan claim re-pointed Claims processor | CLM-413149 → UHC-70663-96 (Austin Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008301 | Orphan claim re-pointed Claims processor | CLM-420302 → UHC-30766-82 (Joshua Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008302 | Orphan claim re-pointed Claims processor | CLM-426155 → UHC-11427-28 (Russell Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008303 | Orphan claim re-pointed Claims processor | CLM-423429 → UHC-26304-24 (Ralph Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008304 | Orphan claim re-pointed Claims processor | CLM-423988 → UHC-63308-42 (Denise Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008305 | Orphan claim re-pointed Claims processor | CLM-401026 → UHC-89960-59 (Maria Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008306 | Orphan claim re-pointed Claims processor | CLM-412563 → UHC-11874-06 (Ryan Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008307 | Orphan claim re-pointed Claims processor | CLM-401807 → UHC-05360-87 (Joyce Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008308 | Orphan claim re-pointed Claims processor | CLM-411929 → UHC-12458-11 (Lawrence Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008309 | Orphan claim re-pointed Claims processor | CLM-410673 → UHC-64891-47 (Jeffrey Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008310 | Orphan claim re-pointed Claims processor | CLM-417628 → UHC-91732-23 (Carolyn Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008311 | Orphan claim re-pointed Claims processor | CLM-429254 → UHC-86504-87 (Mei Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008312 | Orphan claim re-pointed Claims processor | CLM-408440 → UHC-69808-22 (Ralph Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008313 | Orphan claim re-pointed Claims processor | CLM-421710 → UHC-48513-75 (Sophia Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008314 | Orphan claim re-pointed Claims processor | CLM-430787 → UHC-13878-53 (Brittany Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008315 | Orphan claim re-pointed Claims processor | CLM-422055 → UHC-04258-57 (Gregory Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008316 | Orphan claim re-pointed Claims processor | CLM-430957 → UHC-86667-03 (Omar Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008317 | Orphan claim re-pointed Claims processor | CLM-415667 → UHC-84600-88 (Mei Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008318 | Orphan claim re-pointed Claims processor | CLM-418690 → UHC-19774-93 (Billy Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008319 | Orphan claim re-pointed Claims processor | CLM-431769 → UHC-27459-40 (Jose Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008320 | Orphan claim re-pointed Claims processor | CLM-428296 → UHC-05360-90 (Frank Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008321 | Orphan claim re-pointed Claims processor | CLM-402759 → UHC-45402-41 (James Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008322 | Orphan claim re-pointed Claims processor | CLM-424330 → UHC-06410-25 (Bobby Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008323 | Orphan claim re-pointed Claims processor | CLM-408759 → UHC-91272-09 (Timothy Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008324 | Orphan claim re-pointed Claims processor | CLM-430333 → UHC-46032-06 (Diego Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008325 | Orphan claim re-pointed Claims processor | CLM-411539 → UHC-88359-68 (Joseph Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008326 | Orphan claim re-pointed Claims processor | CLM-402772 → UHC-43257-62 (Joseph Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008327 | Orphan claim re-pointed Claims processor | CLM-424498 → UHC-08368-16 (Kyle Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008328 | Orphan claim re-pointed Claims processor | CLM-409690 → UHC-51326-64 (Kelly Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008329 | Orphan claim re-pointed Claims processor | CLM-401077 → UHC-64081-98 (Angela Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008330 | Orphan claim re-pointed Claims processor | CLM-422346 → UHC-81724-28 (Peter Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008331 | Orphan claim re-pointed Claims processor | CLM-413432 → UHC-38840-31 (Stephanie Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008332 | Orphan claim re-pointed Claims processor | CLM-423358 → UHC-80053-21 (Billy Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008333 | Orphan claim re-pointed Claims processor | CLM-430359 → UHC-77648-76 (Jean Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008334 | Orphan claim re-pointed Claims processor | CLM-414085 → UHC-50829-41 (Evelyn Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008335 | Orphan claim re-pointed Claims processor | CLM-409134 → UHC-78843-89 (Don Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008336 | Orphan claim re-pointed Claims processor | CLM-427432 → UHC-71596-90 (Brittany Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008337 | Orphan claim re-pointed Claims processor | CLM-403644 → UHC-35712-96 (Elijah Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008338 | Orphan claim re-pointed Claims processor | CLM-402939 → UHC-66938-15 (Natalie Gommez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008339 | Orphan claim re-pointed Claims processor | CLM-409807 → UHC-42307-61 (Priya Roberts) |
| 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.