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-008740 | Orphan claim re-pointed Claims processor | CLM-432552 → UHC-77837-25 (Charles Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008741 | Orphan claim re-pointed Claims processor | CLM-414430 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008742 | Orphan claim re-pointed Claims processor | CLM-407611 → UHC-87670-08 (Tyler Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008743 | Orphan claim re-pointed Claims processor | CLM-429164 → UHC-70952-79 (Nathan Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008744 | Orphan claim re-pointed Claims processor | CLM-432240 → UHC-70691-50 (Priya Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008745 | Orphan claim re-pointed Claims processor | CLM-416162 → UHC-94976-33 (Kayla Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008746 | Orphan claim re-pointed Claims processor | CLM-410455 → UHC-04893-31 (Patrick Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008747 | Orphan claim re-pointed Claims processor | CLM-402155 → UHC-13174-25 (Rachel Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008748 | Orphan claim re-pointed Claims processor | CLM-400091 → UHC-64388-48 (Peter Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008749 | Orphan claim re-pointed Claims processor | CLM-417289 → UHC-99756-43 (Jacob Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008750 | Orphan claim re-pointed Claims processor | CLM-419446 → UHC-36954-02 (Amanda Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008751 | Orphan claim re-pointed Claims processor | CLM-421020 → UHC-71391-15 (Alice Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008752 | Orphan claim re-pointed Claims processor | CLM-400209 → UHC-36744-15 (Maria Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008753 | Orphan claim re-pointed Claims processor | CLM-403280 → UHC-79249-04 (Madison Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008754 | Orphan claim re-pointed Claims processor | CLM-418622 → UHC-43015-79 (Scott Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008755 | Orphan claim re-pointed Claims processor | CLM-423974 → UHC-86331-58 (Justin Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008756 | Orphan claim re-pointed Claims processor | CLM-414824 → UHC-24125-50 (John Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008757 | Orphan claim re-pointed Claims processor | CLM-415679 → UHC-09108-69 (Shirley Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008758 | Orphan claim re-pointed Claims processor | CLM-416822 → UHC-45838-06 (Nancy Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008759 | Orphan claim re-pointed Claims processor | CLM-418145 → UHC-08787-13 (Mari Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008760 | Orphan claim re-pointed Claims processor | CLM-412456 → UHC-99311-81 (Wayne Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008761 | Orphan claim re-pointed Claims processor | CLM-402597 → UHC-57841-72 (Jerry Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008762 | Orphan claim re-pointed Claims processor | CLM-418066 → UHC-23538-88 (Charls Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008763 | Orphan claim re-pointed Claims processor | CLM-409186 → UHC-17106-67 (Jack Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008764 | Orphan claim re-pointed Claims processor | CLM-424712 → UHC-07807-62 (Dylan Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008765 | Orphan claim re-pointed Claims processor | CLM-402861 → UHC-90305-60 (Randy Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008766 | Orphan claim re-pointed Claims processor | CLM-426500 → UHC-67391-14 (Gregory Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008767 | Orphan claim re-pointed Claims processor | CLM-430945 → UHC-05141-79 (Richard Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008768 | Orphan claim re-pointed Claims processor | CLM-427412 → UHC-79354-74 (Raymond Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008769 | Orphan claim re-pointed Claims processor | CLM-426748 → UHC-68092-51 (Daniel Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008770 | Orphan claim re-pointed Claims processor | CLM-402524 → UHC-83888-95 (Dennis Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008771 | Orphan claim re-pointed Claims processor | CLM-418802 → UHC-57518-79 (Megan Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008772 | Orphan claim re-pointed Claims processor | CLM-402553 → UHC-32025-84 (Harold Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008773 | Orphan claim re-pointed Claims processor | CLM-424399 → UHC-38186-66 (Gregory Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008774 | Orphan claim re-pointed Claims processor | CLM-424441 → UHC-47030-79 (Kenneth Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008775 | Orphan claim re-pointed Claims processor | CLM-421256 → UHC-33766-77 (Brian Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008776 | Orphan claim re-pointed Claims processor | CLM-431193 → UHC-10276-84 (Jordan Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008777 | Orphan claim re-pointed Claims processor | CLM-411882 → UHC-09142-06 (Ahmed Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008778 | Orphan claim re-pointed Claims processor | CLM-428998 → UHC-35790-95 (Andrea Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008779 | Orphan claim re-pointed Claims processor | CLM-413359 → UHC-04677-70 (Ronald Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008780 | Orphan claim re-pointed Claims processor | CLM-409868 → UHC-94718-70 (Santiago Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008781 | Orphan claim re-pointed Claims processor | CLM-419253 → UHC-14938-22 (Andrea King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008782 | Orphan claim re-pointed Claims processor | CLM-426679 → UHC-31365-37 (Rachel Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008783 | Orphan claim re-pointed Claims processor | CLM-431101 → UHC-46389-21 (Kimberly Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008784 | Orphan claim re-pointed Claims processor | CLM-400202 → UHC-84816-78 (Isabella Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008785 | Orphan claim re-pointed Claims processor | CLM-404921 → UHC-04919-14 (Jessica Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008786 | Orphan claim re-pointed Claims processor | CLM-408432 → UHC-12890-38 (Denise Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008787 | Orphan claim re-pointed Claims processor | CLM-403166 → UHC-20636-06 (Ann Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008788 | Orphan claim re-pointed Claims processor | CLM-400089 → UHC-61834-78 (Wei Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008789 | Orphan claim re-pointed Claims processor | CLM-425479 → UHC-41763-34 (Virginia Graham) |
| 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.