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-008640 | Orphan claim re-pointed Claims processor | CLM-408064 → UHC-23423-50 (Emily Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008641 | Orphan claim re-pointed Claims processor | CLM-413255 → UHC-73410-84 (Thomas Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008642 | Orphan claim re-pointed Claims processor | CLM-423079 → UHC-92111-02 (Gary Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008643 | Orphan claim re-pointed Claims processor | CLM-403559 → UHC-52440-42 (Paul Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008644 | Orphan claim re-pointed Claims processor | CLM-424926 → UHC-97244-05 (Doris Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008645 | Orphan claim re-pointed Claims processor | CLM-412587 → UHC-27721-07 (Denise Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008646 | Orphan claim re-pointed Claims processor | CLM-408121 → UHC-22151-31 (Stephen Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008647 | Orphan claim re-pointed Claims processor | CLM-408644 → UHC-99277-69 (Mateo Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008648 | Orphan claim re-pointed Claims processor | CLM-406782 → UHC-69527-63 (Billy Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008649 | Orphan claim re-pointed Claims processor | CLM-421671 → UHC-26275-22 (Scott Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008650 | Orphan claim re-pointed Claims processor | CLM-414291 → UHC-51047-62 (Virginia Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008651 | Orphan claim re-pointed Claims processor | CLM-401359 → UHC-95131-79 (Barbara Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008652 | Orphan claim re-pointed Claims processor | CLM-407137 → UHC-72667-92 (Jason Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008653 | Orphan claim re-pointed Claims processor | CLM-422422 → UHC-94453-11 (Thomas Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008654 | Orphan claim re-pointed Claims processor | CLM-430528 → UHC-48771-18 (Andrea Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008655 | Orphan claim re-pointed Claims processor | CLM-431188 → UHC-02175-32 (Terry Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008656 | Orphan claim re-pointed Claims processor | CLM-411890 → UHC-60653-85 (Ryan Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008657 | Orphan claim re-pointed Claims processor | CLM-415797 → UHC-93730-80 (Sarah Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008658 | Orphan claim re-pointed Claims processor | CLM-417556 → UHC-25544-03 (Billy Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008659 | Orphan claim re-pointed Claims processor | CLM-417956 → UHC-95539-20 (Roger Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008660 | Orphan claim re-pointed Claims processor | CLM-409094 → UHC-33573-55 (Carlos Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008661 | Orphan claim re-pointed Claims processor | CLM-405717 → UHC-56813-67 (Edwad Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008662 | Orphan claim re-pointed Claims processor | CLM-432191 → UHC-85757-15 (Justin Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008663 | Orphan claim re-pointed Claims processor | CLM-418635 → UHC-25731-70 (Sophia Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008664 | Orphan claim re-pointed Claims processor | CLM-419771 → UHC-07964-17 (Hannah Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008665 | Orphan claim re-pointed Claims processor | CLM-428155 → UHC-81983-21 (Priia Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008666 | Orphan claim re-pointed Claims processor | CLM-429120 → UHC-50593-59 (Larry Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008667 | Orphan claim re-pointed Claims processor | CLM-432202 → UHC-78395-46 (Megan Pteers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008668 | Orphan claim re-pointed Claims processor | CLM-406539 → UHC-29520-95 (Elizabeth Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008669 | Orphan claim re-pointed Claims processor | CLM-429508 → UHC-98142-18 (Betty Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008670 | Orphan claim re-pointed Claims processor | CLM-401427 → UHC-10897-78 (Amanda Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008671 | Orphan claim re-pointed Claims processor | CLM-409128 → UHC-03846-84 (Larry Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008672 | Orphan claim re-pointed Claims processor | CLM-406317 → UHC-23688-88 (Bobby Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008673 | Orphan claim re-pointed Claims processor | CLM-410335 → UHC-84886-97 (Abigail Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008674 | Orphan claim re-pointed Claims processor | CLM-405251 → UHC-80809-06 (Randy Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008675 | Orphan claim re-pointed Claims processor | CLM-425653 → UHC-16477-05 (Frank Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008676 | Orphan claim re-pointed Claims processor | CLM-403468 → UHC-23339-51 (Wayne Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008677 | Orphan claim re-pointed Claims processor | CLM-407865 → UHC-73125-42 (Denise Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008678 | Orphan claim re-pointed Claims processor | CLM-414946 → UHC-08695-42 (Donna Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008679 | Orphan claim re-pointed Claims processor | CLM-425134 → UHC-90720-81 (Sara Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008680 | Orphan claim re-pointed Claims processor | CLM-422327 → UHC-95958-18 (Christian Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008681 | Orphan claim re-pointed Claims processor | CLM-428350 → UHC-64195-37 (Frances Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008682 | Orphan claim re-pointed Claims processor | CLM-418632 → UHC-41188-15 (Jonathan Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008683 | Orphan claim re-pointed Claims processor | CLM-416501 → UHC-43078-98 (Gary Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008684 | Orphan claim re-pointed Claims processor | CLM-421326 → UHC-10223-53 (Martha Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008685 | Orphan claim re-pointed Claims processor | CLM-429331 → UHC-01702-71 (Maria Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008686 | Orphan claim re-pointed Claims processor | CLM-422250 → UHC-31187-24 (Daniel Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008687 | Orphan claim re-pointed Claims processor | CLM-432123 → UHC-84480-65 (Jerry Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008688 | Orphan claim re-pointed Claims processor | CLM-401117 → UHC-18443-30 (Jenny Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008689 | Orphan claim re-pointed Claims processor | CLM-400034 → UHC-83497-59 (Martha Stone) |
| 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.