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-009040 | Orphan claim re-pointed Claims processor | CLM-400335 → UHC-82887-97 (Terry Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009041 | Orphan claim re-pointed Claims processor | CLM-423962 → UHC-36576-92 (Aisha Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009042 | Orphan claim re-pointed Claims processor | CLM-403785 → UHC-40507-82 (Timothy Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009043 | Orphan claim re-pointed Claims processor | CLM-411422 → UHC-50653-70 (Virginia Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009044 | Orphan claim re-pointed Claims processor | CLM-400833 → UHC-48716-78 (Gary Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009045 | Orphan claim re-pointed Claims processor | CLM-418927 → UHC-64407-76 (Aaron Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009046 | Orphan claim re-pointed Claims processor | CLM-406836 → UHC-57980-91 (Marilyn Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009047 | Orphan claim re-pointed Claims processor | CLM-416160 → UHC-20024-09 (Camila Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009048 | Orphan claim re-pointed Claims processor | CLM-431376 → UHC-52604-17 (Logan Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009049 | Orphan claim re-pointed Claims processor | CLM-417557 → UHC-46053-84 (Barbara Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009050 | Orphan claim re-pointed Claims processor | CLM-426963 → UHC-45605-61 (Maria Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009051 | Orphan claim re-pointed Claims processor | CLM-411209 → UHC-71144-96 (Eric Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009052 | Orphan claim re-pointed Claims processor | CLM-423865 → UHC-70077-98 (Danielle Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009053 | Orphan claim re-pointed Claims processor | CLM-418451 → UHC-00538-61 (Bradley Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009054 | Orphan claim re-pointed Claims processor | CLM-418272 → UHC-26269-59 (Shirley Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009055 | Orphan claim re-pointed Claims processor | CLM-427693 → UHC-54769-51 (Amy Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009056 | Orphan claim re-pointed Claims processor | CLM-417525 → UHC-52925-80 (Marilyn King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009057 | Orphan claim re-pointed Claims processor | CLM-401422 → UHC-90638-23 (Sandra Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009058 | Orphan claim re-pointed Claims processor | CLM-413157 → UHC-95210-09 (Zachary Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009059 | Orphan claim re-pointed Claims processor | CLM-421503 → UHC-47481-78 (Frank Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009060 | Orphan claim re-pointed Claims processor | CLM-411029 → UHC-46103-72 (Carolyn Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009061 | Orphan claim re-pointed Claims processor | CLM-401343 → UHC-03456-11 (Zachary Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009062 | Orphan claim re-pointed Claims processor | CLM-405468 → UHC-79258-59 (Melissa Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009063 | Orphan claim re-pointed Claims processor | CLM-423835 → UHC-55876-27 (Alan Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009064 | Orphan claim re-pointed Claims processor | CLM-411857 → UHC-29394-99 (Jason Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009065 | Orphan claim re-pointed Claims processor | CLM-422714 → UHC-36853-49 (Charlotte Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009066 | Orphan claim re-pointed Claims processor | CLM-427053 → UHC-32542-57 (Bryan Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009067 | Orphan claim re-pointed Claims processor | CLM-419222 → UHC-63613-61 (Amy Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009068 | Orphan claim re-pointed Claims processor | CLM-408381 → UHC-19239-27 (Nicholas Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009069 | Orphan claim re-pointed Claims processor | CLM-412918 → UHC-42304-14 (Gerald Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009070 | Orphan claim re-pointed Claims processor | CLM-424827 → UHC-94641-83 (Elizabeth Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009071 | Orphan claim re-pointed Claims processor | CLM-417955 → UHC-95539-20 (Roger Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009072 | Orphan claim re-pointed Claims processor | CLM-419887 → UHC-92358-31 (Brian Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009073 | Orphan claim re-pointed Claims processor | CLM-421233 → UHC-43076-62 (Timothy Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009074 | Orphan claim re-pointed Claims processor | CLM-402803 → UHC-56451-68 (Kimberly Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009075 | Orphan claim re-pointed Claims processor | CLM-410686 → UHC-75619-36 (Thomas Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009076 | Orphan claim re-pointed Claims processor | CLM-409935 → UHC-32487-12 (Thomas Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009077 | Orphan claim re-pointed Claims processor | CLM-427203 → UHC-24086-77 (William Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009078 | Orphan claim re-pointed Claims processor | CLM-401843 → UHC-82152-40 (Madison Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009079 | Orphan claim re-pointed Claims processor | CLM-409874 → UHC-39148-39 (Diane Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009080 | Orphan claim re-pointed Claims processor | CLM-427129 → UHC-90800-35 (Stephanie Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009081 | Orphan claim re-pointed Claims processor | CLM-411598 → UHC-35705-58 (Michael Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009082 | Orphan claim re-pointed Claims processor | CLM-432473 → UHC-15581-31 (Juan Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009083 | Orphan claim re-pointed Claims processor | CLM-416636 → UHC-16347-57 (Ann Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009084 | Orphan claim re-pointed Claims processor | CLM-405999 → UHC-74830-37 (Wayne Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009085 | Orphan claim re-pointed Claims processor | CLM-414350 → UHC-42128-21 (Wei Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009086 | Orphan claim re-pointed Claims processor | CLM-409343 → UHC-59843-65 (Stephen McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009087 | Orphan claim re-pointed Claims processor | CLM-425255 → UHC-36645-75 (Sophia Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009088 | Orphan claim re-pointed Claims processor | CLM-401145 → UHC-11161-09 (Victoria Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009089 | Orphan claim re-pointed Claims processor | CLM-405758 → UHC-38509-24 (Kathleen Taylor) |
| 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.