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-009390 | Orphan claim re-pointed Claims processor | CLM-431619 → UHC-61305-53 (Evelyn Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009391 | Orphan claim re-pointed Claims processor | CLM-407656 → UHC-72721-98 (Rebecca Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009392 | Orphan claim re-pointed Claims processor | CLM-421433 → UHC-68694-09 (Martha Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009393 | Orphan claim re-pointed Claims processor | CLM-400543 → UHC-49030-70 (Bryan Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009394 | Orphan claim re-pointed Claims processor | CLM-414762 → UHC-19964-84 (Sofia Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009395 | Orphan claim re-pointed Claims processor | CLM-403049 → UHC-36033-31 (Ethan Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009396 | Orphan claim re-pointed Claims processor | CLM-420350 → UHC-67550-86 (Helen Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009397 | Orphan claim re-pointed Claims processor | CLM-404831 → UHC-59481-37 (Laura Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009398 | Orphan claim re-pointed Claims processor | CLM-420164 → UHC-90658-11 (Christine Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009399 | Orphan claim re-pointed Claims processor | CLM-403147 → UHC-23284-60 (Margaret James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009400 | Orphan claim re-pointed Claims processor | CLM-407515 → UHC-97544-20 (Lawrence Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009401 | Orphan claim re-pointed Claims processor | CLM-407305 → UHC-91879-89 (Judith Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009402 | Orphan claim re-pointed Claims processor | CLM-401325 → UHC-20084-25 (Logan Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009403 | Orphan claim re-pointed Claims processor | CLM-420780 → UHC-15397-39 (Benjamin Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009404 | Orphan claim re-pointed Claims processor | CLM-409545 → UHC-27048-49 (Angela Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009405 | Orphan claim re-pointed Claims processor | CLM-411700 → UHC-58436-86 (Mateo King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009406 | Orphan claim re-pointed Claims processor | CLM-404951 → UHC-57723-01 (Logan Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009407 | Orphan claim re-pointed Claims processor | CLM-417948 → UHC-11656-07 (Judy Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009408 | Orphan claim re-pointed Claims processor | CLM-400561 → UHC-02160-38 (Madison Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009409 | Orphan claim re-pointed Claims processor | CLM-425614 → UHC-76572-73 (Bryn Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009410 | Orphan claim re-pointed Claims processor | CLM-408453 → UHC-89838-16 (Lawrence Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009411 | Orphan claim re-pointed Claims processor | CLM-425524 → UHC-06856-30 (Cynthia Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009412 | Orphan claim re-pointed Claims processor | CLM-408684 → UHC-68333-42 (Elijah Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009413 | Orphan claim re-pointed Claims processor | CLM-405314 → UHC-90175-74 (George Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009414 | Orphan claim re-pointed Claims processor | CLM-420026 → UHC-42568-66 (Kayla Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009415 | Orphan claim re-pointed Claims processor | CLM-417641 → UHC-53370-86 (Anthony Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009416 | Orphan claim re-pointed Claims processor | CLM-408376 → UHC-38783-47 (Ronald Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009417 | Orphan claim re-pointed Claims processor | CLM-426596 → UHC-50698-88 (Judy Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009418 | Orphan claim re-pointed Claims processor | CLM-406419 → UHC-55108-53 (Christina Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009419 | Orphan claim re-pointed Claims processor | CLM-408019 → UHC-19098-18 (Diana Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009420 | Orphan claim re-pointed Claims processor | CLM-406755 → UHC-86550-84 (Sophia Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009421 | Orphan claim re-pointed Claims processor | CLM-421873 → UHC-83749-71 (Helen Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009422 | Orphan claim re-pointed Claims processor | CLM-420918 → UHC-50807-87 (Jacqueline Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009423 | Orphan claim re-pointed Claims processor | CLM-412787 → UHC-38991-46 (Vincent Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009424 | Orphan claim re-pointed Claims processor | CLM-410020 → UHC-88472-34 (Jose Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009425 | Orphan claim re-pointed Claims processor | CLM-420175 → UHC-32813-59 (Jessica Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009426 | Orphan claim re-pointed Claims processor | CLM-421683 → UHC-23045-19 (Omar Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009427 | Orphan claim re-pointed Claims processor | CLM-400826 → UHC-52599-41 (Donald Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009428 | Orphan claim re-pointed Claims processor | CLM-430568 → UHC-53365-30 (Diane Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009429 | Orphan claim re-pointed Claims processor | CLM-412686 → UHC-32664-98 (Isabella Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009430 | Orphan claim re-pointed Claims processor | CLM-403013 → UHC-31609-62 (Elizabeth Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009431 | Orphan claim re-pointed Claims processor | CLM-412607 → UHC-30198-60 (Lisa Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009432 | Orphan claim re-pointed Claims processor | CLM-413881 → UHC-16231-67 (Carol Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009433 | Orphan claim re-pointed Claims processor | CLM-400527 → UHC-59529-24 (George Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009434 | Orphan claim re-pointed Claims processor | CLM-407990 → UHC-31120-14 (Samantha Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009435 | Orphan claim re-pointed Claims processor | CLM-428899 → UHC-24739-99 (Barbara Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009436 | Orphan claim re-pointed Claims processor | CLM-415266 → UHC-91600-43 (Albert Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009437 | Orphan claim re-pointed Claims processor | CLM-430620 → UHC-23080-10 (Timothy Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009438 | Orphan claim re-pointed Claims processor | CLM-416468 → UHC-38030-55 (Gregory Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009439 | Orphan claim re-pointed Claims processor | CLM-408166 → UHC-23171-99 (Charlotte Vega) |
| 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.