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-008990 | Orphan claim re-pointed Claims processor | CLM-420592 → UHC-58924-41 (Kimberly Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008991 | Orphan claim re-pointed Claims processor | CLM-412934 → UHC-71613-42 (Cheryl Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008992 | Orphan claim re-pointed Claims processor | CLM-416297 → UHC-57216-19 (Arjun Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008993 | Orphan claim re-pointed Claims processor | CLM-425938 → UHC-06364-64 (Amanda Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008994 | Orphan claim re-pointed Claims processor | CLM-409468 → UHC-17819-97 (Sara Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008995 | Orphan claim re-pointed Claims processor | CLM-419484 → UHC-69388-74 (Willie Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008996 | Orphan claim re-pointed Claims processor | CLM-402580 → UHC-16722-55 (Teresa McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008997 | Orphan claim re-pointed Claims processor | CLM-432003 → UHC-29783-22 (Matthew Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008998 | Orphan claim re-pointed Claims processor | CLM-411103 → UHC-05848-56 (Hannah Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008999 | Orphan claim re-pointed Claims processor | CLM-425850 → UHC-87750-98 (Carl Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009000 | Orphan claim re-pointed Claims processor | CLM-416018 → UHC-49073-83 (Fatima Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009001 | Orphan claim re-pointed Claims processor | CLM-426100 → UHC-59503-45 (Beverly Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009002 | Orphan claim re-pointed Claims processor | CLM-410197 → UHC-12259-79 (Kevin Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009003 | Orphan claim re-pointed Claims processor | CLM-429693 → UHC-58043-65 (Sean Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009004 | Orphan claim re-pointed Claims processor | CLM-421791 → UHC-24932-16 (Stephen Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009005 | Orphan claim re-pointed Claims processor | CLM-429649 → UHC-48764-80 (Zachary Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009006 | Orphan claim re-pointed Claims processor | CLM-413199 → UHC-90118-21 (Teresa Andreson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009007 | Orphan claim re-pointed Claims processor | CLM-427739 → UHC-66385-91 (Don Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009008 | Orphan claim re-pointed Claims processor | CLM-427676 → UHC-71603-21 (Pamela Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009009 | Orphan claim re-pointed Claims processor | CLM-415935 → UHC-22640-53 (Benjamin Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009010 | Orphan claim re-pointed Claims processor | CLM-412890 → UHC-57312-65 (Andrea Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009011 | Orphan claim re-pointed Claims processor | CLM-400053 → UHC-83472-91 (Diane Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009012 | Orphan claim re-pointed Claims processor | CLM-415258 → UHC-99761-49 (Keith Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009013 | Orphan claim re-pointed Claims processor | CLM-421049 → UHC-74848-26 (Jessica Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009014 | Orphan claim re-pointed Claims processor | CLM-431973 → UHC-27099-22 (Ethan Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009015 | Orphan claim re-pointed Claims processor | CLM-409208 → UHC-33869-68 (Jonathan Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009016 | Orphan claim re-pointed Claims processor | CLM-432677 → UHC-88110-90 (Rachel Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009017 | Orphan claim re-pointed Claims processor | CLM-419390 → UHC-59973-87 (Patrick Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009018 | Orphan claim re-pointed Claims processor | CLM-418912 → UHC-63669-97 (Natalie Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009019 | Orphan claim re-pointed Claims processor | CLM-420889 → UHC-50453-29 (Doris Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009020 | Orphan claim re-pointed Claims processor | CLM-415112 → UHC-29751-78 (Maria Motgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009021 | Orphan claim re-pointed Claims processor | CLM-420497 → UHC-40942-62 (Albert Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009022 | Orphan claim re-pointed Claims processor | CLM-428434 → UHC-23457-56 (Cheryl Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009023 | Orphan claim re-pointed Claims processor | CLM-400913 → UHC-81585-75 (Gloria Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009024 | Orphan claim re-pointed Claims processor | CLM-430605 → UHC-19967-99 (Patricia Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009025 | Orphan claim re-pointed Claims processor | CLM-430273 → UHC-76821-72 (Paul Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009026 | Orphan claim re-pointed Claims processor | CLM-422296 → UHC-94558-28 (Wei Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009027 | Orphan claim re-pointed Claims processor | CLM-406220 → UHC-50985-91 (Denise Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009028 | Orphan claim re-pointed Claims processor | CLM-423326 → UHC-58401-45 (Matthew Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009029 | Orphan claim re-pointed Claims processor | CLM-431831 → UHC-81705-80 (Maria Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009030 | Orphan claim re-pointed Claims processor | CLM-412985 → UHC-09672-15 (Katherine Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009031 | Orphan claim re-pointed Claims processor | CLM-417973 → UHC-59084-32 (Christian Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009032 | Orphan claim re-pointed Claims processor | CLM-403322 → UHC-76050-53 (Luis Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009033 | Orphan claim re-pointed Claims processor | CLM-401165 → UHC-93945-67 (Natalie Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009034 | Orphan claim re-pointed Claims processor | CLM-426471 → UHC-63347-73 (Deborah Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009035 | Orphan claim re-pointed Claims processor | CLM-427852 → UHC-63375-90 (Catherine Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009036 | Orphan claim re-pointed Claims processor | CLM-405044 → UHC-00623-94 (Kathleen Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009037 | Orphan claim re-pointed Claims processor | CLM-417220 → UHC-47337-39 (Gregory Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009038 | Orphan claim re-pointed Claims processor | CLM-407196 → UHC-35997-95 (Brandon Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009039 | Orphan claim re-pointed Claims processor | CLM-424663 → UHC-65482-05 (Kayla Willis) |
| 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.