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-009440 | Orphan claim re-pointed Claims processor | CLM-414635 → UHC-71285-92 (Evelyn Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009441 | Orphan claim re-pointed Claims processor | CLM-425500 → UHC-70390-48 (Randy Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009442 | Orphan claim re-pointed Claims processor | CLM-415996 → UHC-94891-67 (Larry Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009443 | Orphan claim re-pointed Claims processor | CLM-413227 → UHC-64773-95 (Alexis Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009444 | Orphan claim re-pointed Claims processor | CLM-402718 → UHC-53560-72 (Ray Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009445 | Orphan claim re-pointed Claims processor | CLM-414019 → UHC-61760-09 (Elijah Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009446 | Orphan claim re-pointed Claims processor | CLM-426998 → UHC-87623-30 (Marc Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009447 | Orphan claim re-pointed Claims processor | CLM-426018 → UHC-99616-93 (Albert Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009448 | Orphan claim re-pointed Claims processor | CLM-427458 → UHC-15113-79 (Steve Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009449 | Orphan claim re-pointed Claims processor | CLM-409765 → UHC-07795-75 (Jeremy Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009450 | Orphan claim re-pointed Claims processor | CLM-414220 → UHC-20492-19 (Andrew Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009451 | Orphan claim re-pointed Claims processor | CLM-418576 → UHC-44307-53 (Keith Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009452 | Orphan claim re-pointed Claims processor | CLM-432271 → UHC-22297-46 (Lisa Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009453 | Orphan claim re-pointed Claims processor | CLM-402345 → UHC-90751-15 (Ana Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009454 | Orphan claim re-pointed Claims processor | CLM-431939 → UHC-90646-41 (Diego Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009455 | Orphan claim re-pointed Claims processor | CLM-425427 → UHC-55391-43 (Alexander Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009456 | Orphan claim re-pointed Claims processor | CLM-412029 → UHC-49736-31 (Grace Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009457 | Orphan claim re-pointed Claims processor | CLM-415345 → UHC-62241-74 (George Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009458 | Orphan claim re-pointed Claims processor | CLM-410177 → UHC-49111-77 (Henry McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009459 | Orphan claim re-pointed Claims processor | CLM-402112 → UHC-97508-22 (Daniel Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009460 | Orphan claim re-pointed Claims processor | CLM-421399 → UHC-13774-38 (Charles Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009461 | Orphan claim re-pointed Claims processor | CLM-432438 → UHC-33009-48 (Grace McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009462 | Orphan claim re-pointed Claims processor | CLM-411379 → UHC-58441-16 (Stephen Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009463 | Orphan claim re-pointed Claims processor | CLM-405793 → UHC-68970-84 (Walter Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009464 | Orphan claim re-pointed Claims processor | CLM-406100 → UHC-28520-62 (Evelyn Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009465 | Orphan claim re-pointed Claims processor | CLM-402987 → UHC-59025-32 (Carolyn Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009466 | Orphan claim re-pointed Claims processor | CLM-421169 → UHC-14105-31 (Priya Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009467 | Orphan claim re-pointed Claims processor | CLM-422450 → UHC-91224-18 (Dylan Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009468 | Orphan claim re-pointed Claims processor | CLM-400317 → UHC-13066-46 (Keith Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009469 | Orphan claim re-pointed Claims processor | CLM-421584 → UHC-06869-63 (Helen Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009470 | Orphan claim re-pointed Claims processor | CLM-427280 → UHC-29797-34 (George Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009471 | Orphan claim re-pointed Claims processor | CLM-432584 → UHC-64454-23 (Alan Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009472 | Orphan claim re-pointed Claims processor | CLM-413471 → UHC-80735-98 (Jonathan Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009473 | Orphan claim re-pointed Claims processor | CLM-431537 → UHC-98440-07 (Amanda Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009474 | Orphan claim re-pointed Claims processor | CLM-426821 → UHC-98034-10 (Rebecca Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009475 | Orphan claim re-pointed Claims processor | CLM-401499 → UHC-64428-98 (Judith Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009476 | Orphan claim re-pointed Claims processor | CLM-412043 → UHC-18362-92 (Scott Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009477 | Orphan claim re-pointed Claims processor | CLM-424078 → UHC-85847-31 (Hannah Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009478 | Orphan claim re-pointed Claims processor | CLM-424907 → UHC-29007-63 (Diego Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009479 | Orphan claim re-pointed Claims processor | CLM-405043 → UHC-21653-62 (Matthew Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009480 | Orphan claim re-pointed Claims processor | CLM-421751 → UHC-28565-63 (Dylan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009481 | Orphan claim re-pointed Claims processor | CLM-407668 → UHC-95333-52 (Kevin Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009482 | Orphan claim re-pointed Claims processor | CLM-412523 → UHC-58414-02 (Lawrence Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009483 | Orphan claim re-pointed Claims processor | CLM-408908 → UHC-88067-96 (Jose Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009484 | Orphan claim re-pointed Claims processor | CLM-429329 → UHC-56998-94 (Bryan Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009485 | Orphan claim re-pointed Claims processor | CLM-416098 → UHC-85770-80 (Jeremy Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009486 | Orphan claim re-pointed Claims processor | CLM-412507 → UHC-05448-55 (Virginia Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009487 | Orphan claim re-pointed Claims processor | CLM-415736 → UHC-78951-31 (Brian Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009488 | Orphan claim re-pointed Claims processor | CLM-428464 → UHC-52947-73 (Megan Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009489 | Orphan claim re-pointed Claims processor | CLM-419442 → UHC-78243-99 (Brenda Lewis) |
| 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.