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-008790 | Orphan claim re-pointed Claims processor | CLM-422482 → UHC-65025-01 (Bobby Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008791 | Orphan claim re-pointed Claims processor | CLM-426115 → UHC-98861-75 (Mateo Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008792 | Orphan claim re-pointed Claims processor | CLM-418881 → UHC-32019-99 (Anna Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008793 | Orphan claim re-pointed Claims processor | CLM-416376 → UHC-28975-92 (Timothy Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008794 | Orphan claim re-pointed Claims processor | CLM-430394 → UHC-74719-65 (Douglas Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008795 | Orphan claim re-pointed Claims processor | CLM-425880 → UHC-85627-10 (Robert Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008796 | Orphan claim re-pointed Claims processor | CLM-420890 → UHC-50453-29 (Doris Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008797 | Orphan claim re-pointed Claims processor | CLM-429924 → UHC-40496-41 (Stephen Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008798 | Orphan claim re-pointed Claims processor | CLM-428039 → UHC-13090-50 (Daniel Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008799 | Orphan claim re-pointed Claims processor | CLM-413859 → UHC-52436-99 (Jose Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008800 | Orphan claim re-pointed Claims processor | CLM-429186 → UHC-85185-79 (Eric Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008801 | Orphan claim re-pointed Claims processor | CLM-426163 → UHC-16125-24 (Albert Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008802 | Orphan claim re-pointed Claims processor | CLM-422947 → UHC-40645-66 (Betty Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008803 | Orphan claim re-pointed Claims processor | CLM-412220 → UHC-67757-69 (Ahmed Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008804 | Orphan claim re-pointed Claims processor | CLM-410811 → UHC-06257-82 (Nicole Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008805 | Orphan claim re-pointed Claims processor | CLM-420632 → UHC-64545-68 (Beverly Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008806 | Orphan claim re-pointed Claims processor | CLM-402584 → UHC-47581-55 (Lawrence Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008807 | Orphan claim re-pointed Claims processor | CLM-429011 → UHC-43838-09 (Henry Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008808 | Orphan claim re-pointed Claims processor | CLM-420455 → UHC-08987-22 (Janet Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008809 | Orphan claim re-pointed Claims processor | CLM-430747 → UHC-47320-20 (Sara Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008810 | Orphan claim re-pointed Claims processor | CLM-411042 → UHC-48330-57 (Douglas Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008811 | Orphan claim re-pointed Claims processor | CLM-431689 → UHC-71794-17 (Jacqueline Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008812 | Orphan claim re-pointed Claims processor | CLM-421516 → UHC-47416-37 (Dylan Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008813 | Orphan claim re-pointed Claims processor | CLM-414109 → UHC-26336-25 (Walter Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008814 | Orphan claim re-pointed Claims processor | CLM-413854 → UHC-75927-48 (Karen Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008815 | Orphan claim re-pointed Claims processor | CLM-431662 → UHC-83196-09 (James Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008816 | Orphan claim re-pointed Claims processor | CLM-425210 → UHC-69833-28 (Helen Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008817 | Orphan claim re-pointed Claims processor | CLM-419746 → UHC-48953-93 (Tyler Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008818 | Orphan claim re-pointed Claims processor | CLM-405036 → UHC-07597-48 (Carlos Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008819 | Orphan claim re-pointed Claims processor | CLM-415732 → UHC-52616-48 (William Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008820 | Orphan claim re-pointed Claims processor | CLM-400036 → UHC-48669-35 (Omar Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008821 | Orphan claim re-pointed Claims processor | CLM-424002 → UHC-48367-52 (Willie Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008822 | Orphan claim re-pointed Claims processor | CLM-415809 → UHC-24101-25 (Fatima Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008823 | Orphan claim re-pointed Claims processor | CLM-403777 → UHC-85597-57 (Nicole Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008824 | Orphan claim re-pointed Claims processor | CLM-422904 → UHC-24119-60 (Eugene Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008825 | Orphan claim re-pointed Claims processor | CLM-402620 → UHC-69723-76 (Julie Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008826 | Orphan claim re-pointed Claims processor | CLM-422991 → UHC-73466-21 (Joe Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008827 | Orphan claim re-pointed Claims processor | CLM-419110 → UHC-67085-21 (Brian Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008828 | Orphan claim re-pointed Claims processor | CLM-402316 → UHC-64640-18 (Laura Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008829 | Orphan claim re-pointed Claims processor | CLM-419732 → UHC-05699-88 (Donna Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008830 | Orphan claim re-pointed Claims processor | CLM-417294 → UHC-60299-61 (Paul Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008831 | Orphan claim re-pointed Claims processor | CLM-428363 → UHC-84690-46 (Bradley Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008832 | Orphan claim re-pointed Claims processor | CLM-401377 → UHC-37963-95 (Kathryn Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008833 | Orphan claim re-pointed Claims processor | CLM-428054 → UHC-28654-06 (Sharon Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008834 | Orphan claim re-pointed Claims processor | CLM-432453 → UHC-56127-37 (Douglas Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008835 | Orphan claim re-pointed Claims processor | CLM-429449 → UHC-73700-75 (Christina Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008836 | Orphan claim re-pointed Claims processor | CLM-425652 → UHC-69000-23 (Lisa Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008837 | Orphan claim re-pointed Claims processor | CLM-416140 → UHC-61680-99 (Karen Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008838 | Orphan claim re-pointed Claims processor | CLM-416522 → UHC-44389-91 (Grace Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008839 | Orphan claim re-pointed Claims processor | CLM-408825 → UHC-88397-72 (Charlotte Alexander) |
| 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.