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-008940 | Orphan claim re-pointed Claims processor | CLM-413475 → UHC-23662-24 (Stephen Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008941 | Orphan claim re-pointed Claims processor | CLM-411313 → UHC-37285-52 (Judy Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008942 | Orphan claim re-pointed Claims processor | CLM-431562 → UHC-34719-91 (Beverly George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008943 | Orphan claim re-pointed Claims processor | CLM-428484 → UHC-55950-56 (Carol King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008944 | Orphan claim re-pointed Claims processor | CLM-403148 → UHC-23284-60 (Margaret James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008945 | Orphan claim re-pointed Claims processor | CLM-409558 → UHC-77073-62 (Diana Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008946 | Orphan claim re-pointed Claims processor | CLM-401051 → UHC-19364-47 (Rebecca Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008947 | Orphan claim re-pointed Claims processor | CLM-402017 → UHC-66052-13 (Raymond Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008948 | Orphan claim re-pointed Claims processor | CLM-414184 → UHC-84213-13 (Joseph Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008949 | Orphan claim re-pointed Claims processor | CLM-419122 → UHC-07841-77 (Jacob Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008950 | Orphan claim re-pointed Claims processor | CLM-413897 → UHC-71588-63 (Mason Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008951 | Orphan claim re-pointed Claims processor | CLM-428251 → UHC-77157-46 (Henry Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008952 | Orphan claim re-pointed Claims processor | CLM-414069 → UHC-38848-23 (Maria Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008953 | Orphan claim re-pointed Claims processor | CLM-420682 → UHC-43295-81 (Billy Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008954 | Orphan claim re-pointed Claims processor | CLM-424963 → UHC-66686-95 (Ahmed Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008955 | Orphan claim re-pointed Claims processor | CLM-419953 → UHC-11203-18 (Abigail Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008956 | Orphan claim re-pointed Claims processor | CLM-419423 → UHC-58223-62 (Joshua Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008957 | Orphan claim re-pointed Claims processor | CLM-427641 → UHC-57924-01 (Shirley Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008958 | Orphan claim re-pointed Claims processor | CLM-431846 → UHC-43497-04 (Ruth Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008959 | Orphan claim re-pointed Claims processor | CLM-407525 → UHC-71535-19 (Kelly Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008960 | Orphan claim re-pointed Claims processor | CLM-419450 → UHC-41138-39 (Willie Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008961 | Orphan claim re-pointed Claims processor | CLM-407487 → UHC-58089-01 (Mason Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008962 | Orphan claim re-pointed Claims processor | CLM-400730 → UHC-76291-34 (Jacob Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008963 | Orphan claim re-pointed Claims processor | CLM-427065 → UHC-07204-04 (Ana Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008964 | Orphan claim re-pointed Claims processor | CLM-404555 → UHC-68737-10 (Julie Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008965 | Orphan claim re-pointed Claims processor | CLM-406823 → UHC-27865-67 (Amy Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008966 | Orphan claim re-pointed Claims processor | CLM-406214 → UHC-59936-83 (Jerry Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008967 | Orphan claim re-pointed Claims processor | CLM-414881 → UHC-97785-65 (Joan Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008968 | Orphan claim re-pointed Claims processor | CLM-427210 → UHC-97143-27 (Rachel Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008969 | Orphan claim re-pointed Claims processor | CLM-431656 → UHC-54582-64 (Karen Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008970 | Orphan claim re-pointed Claims processor | CLM-428259 → UHC-72048-32 (John Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008971 | Orphan claim re-pointed Claims processor | CLM-420524 → UHC-80996-85 (Denise Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008972 | Orphan claim re-pointed Claims processor | CLM-430236 → UHC-31119-14 (Ana Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008973 | Orphan claim re-pointed Claims processor | CLM-406150 → UHC-66676-87 (Lori Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008974 | Orphan claim re-pointed Claims processor | CLM-403258 → UHC-31213-74 (Adam Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008975 | Orphan claim re-pointed Claims processor | CLM-419015 → UHC-05392-10 (Joyce Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008976 | Orphan claim re-pointed Claims processor | CLM-403971 → UHC-48286-43 (Kenneth Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008977 | Orphan claim re-pointed Claims processor | CLM-427699 → UHC-33223-95 (Katherine West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008978 | Orphan claim re-pointed Claims processor | CLM-406507 → UHC-92335-51 (Jordan Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008979 | Orphan claim re-pointed Claims processor | CLM-409889 → UHC-42978-12 (Linda Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008980 | Orphan claim re-pointed Claims processor | CLM-405894 → UHC-78188-24 (Debra Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008981 | Orphan claim re-pointed Claims processor | CLM-412979 → UHC-11615-56 (Ruth Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008982 | Orphan claim re-pointed Claims processor | CLM-412289 → UHC-97692-50 (Noah Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008983 | Orphan claim re-pointed Claims processor | CLM-413650 → UHC-37193-34 (Fatima Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008984 | Orphan claim re-pointed Claims processor | CLM-411426 → UHC-18511-80 (Timoty Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008985 | Orphan claim re-pointed Claims processor | CLM-406664 → UHC-33930-18 (Pamela Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008986 | Orphan claim re-pointed Claims processor | CLM-418874 → UHC-44238-24 (Joseph Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008987 | Orphan claim re-pointed Claims processor | CLM-426530 → UHC-47323-56 (Kimberly Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008988 | Orphan claim re-pointed Claims processor | CLM-409454 → UHC-06553-73 (Pamela Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008989 | Orphan claim re-pointed Claims processor | CLM-400316 → UHC-13066-46 (Keith Collins) |
| 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.