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-008690 | Orphan claim re-pointed Claims processor | CLM-415236 → UHC-13034-91 (Jacqueline Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008691 | Orphan claim re-pointed Claims processor | CLM-420708 → UHC-67334-94 (Dennis Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008692 | Orphan claim re-pointed Claims processor | CLM-407002 → UHC-82854-83 (Priya Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008693 | Orphan claim re-pointed Claims processor | CLM-427191 → UHC-95608-45 (Kayla Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008694 | Orphan claim re-pointed Claims processor | CLM-401458 → UHC-91693-71 (Albert Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008695 | Orphan claim re-pointed Claims processor | CLM-417270 → UHC-81821-18 (Lori Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008696 | Orphan claim re-pointed Claims processor | CLM-407629 → UHC-76671-82 (Alexis Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008697 | Orphan claim re-pointed Claims processor | CLM-427547 → UHC-39044-49 (Donna Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008698 | Orphan claim re-pointed Claims processor | CLM-414685 → UHC-29633-39 (Alice Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008699 | Orphan claim re-pointed Claims processor | CLM-411767 → UHC-90090-71 (Alice Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008700 | Orphan claim re-pointed Claims processor | CLM-428214 → UHC-54661-78 (Juan Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008701 | Orphan claim re-pointed Claims processor | CLM-423061 → UHC-42219-38 (Judy Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008702 | Orphan claim re-pointed Claims processor | CLM-402040 → UHC-05685-10 (Mark Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008703 | Orphan claim re-pointed Claims processor | CLM-413628 → UHC-64031-66 (Keith Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008704 | Orphan claim re-pointed Claims processor | CLM-429330 → UHC-01702-71 (Maria Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008705 | Orphan claim re-pointed Claims processor | CLM-407538 → UHC-41415-62 (Virginia Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008706 | Orphan claim re-pointed Claims processor | CLM-422936 → UHC-58050-50 (Susan Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008707 | Orphan claim re-pointed Claims processor | CLM-413020 → UHC-70320-01 (Juan Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008708 | Orphan claim re-pointed Claims processor | CLM-416543 → UHC-29228-29 (Janet Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008709 | Orphan claim re-pointed Claims processor | CLM-417582 → UHC-15384-70 (Andrew Lawis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008710 | Orphan claim re-pointed Claims processor | CLM-421838 → UHC-51782-76 (Zachary Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008711 | Orphan claim re-pointed Claims processor | CLM-430025 → UHC-80712-12 (Natalie Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008712 | Orphan claim re-pointed Claims processor | CLM-423847 → UHC-04022-90 (Lauren Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008713 | Orphan claim re-pointed Claims processor | CLM-414998 → UHC-38052-66 (Brenda Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008714 | Orphan claim re-pointed Claims processor | CLM-406627 → UHC-92202-30 (Jacob Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008715 | Orphan claim re-pointed Claims processor | CLM-402924 → UHC-46319-99 (Bettty Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008716 | Orphan claim re-pointed Claims processor | CLM-425798 → UHC-39394-42 (Jordan Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008717 | Orphan claim re-pointed Claims processor | CLM-415953 → UHC-66554-95 (Madison Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008718 | Orphan claim re-pointed Claims processor | CLM-416183 → UHC-44621-94 (David Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008719 | Orphan claim re-pointed Claims processor | CLM-406888 → UHC-96152-36 (Priya Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008720 | Orphan claim re-pointed Claims processor | CLM-417456 → UHC-64924-50 (Danielle Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008721 | Orphan claim re-pointed Claims processor | CLM-405701 → UHC-52121-96 (Amanda Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008722 | Orphan claim re-pointed Claims processor | CLM-423104 → UHC-47867-27 (Megan Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008723 | Orphan claim re-pointed Claims processor | CLM-407084 → UHC-77574-52 (Bryan Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008724 | Orphan claim re-pointed Claims processor | CLM-404796 → UHC-83247-86 (Shirley Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008725 | Orphan claim re-pointed Claims processor | CLM-425830 → UHC-26876-34 (Walter Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008726 | Orphan claim re-pointed Claims processor | CLM-412361 → UHC-06876-95 (Bobby Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008727 | Orphan claim re-pointed Claims processor | CLM-422999 → UHC-98151-85 (Kathleen Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008728 | Orphan claim re-pointed Claims processor | CLM-413102 → UHC-67014-51 (Kelly Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008729 | Orphan claim re-pointed Claims processor | CLM-424347 → UHC-51683-44 (Teresa Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008730 | Orphan claim re-pointed Claims processor | CLM-412701 → UHC-74593-20 (Abigail Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008731 | Orphan claim re-pointed Claims processor | CLM-420113 → UHC-76497-80 (Rebecca Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008732 | Orphan claim re-pointed Claims processor | CLM-422201 → UHC-44361-63 (Henry Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008733 | Orphan claim re-pointed Claims processor | CLM-429028 → UHC-09729-29 (Bradley Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008734 | Orphan claim re-pointed Claims processor | CLM-415757 → UHC-55567-38 (Michael Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008735 | Orphan claim re-pointed Claims processor | CLM-404064 → UHC-57361-78 (Judith Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008736 | Orphan claim re-pointed Claims processor | CLM-424058 → UHC-77797-13 (Nicholas Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008737 | Orphan claim re-pointed Claims processor | CLM-417776 → UHC-42386-79 (Patricia Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008738 | Orphan claim re-pointed Claims processor | CLM-427295 → UHC-77349-09 (Cheryl Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008739 | Orphan claim re-pointed Claims processor | CLM-416662 → UHC-14238-55 (Janice Estrada) |
| 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.