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-009490 | Orphan claim re-pointed Claims processor | CLM-409900 → UHC-09453-25 (Martha Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009491 | Orphan claim re-pointed Claims processor | CLM-425481 → UHC-32707-31 (Patrick Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009492 | Orphan claim re-pointed Claims processor | CLM-407823 → UHC-17323-63 (Wayne Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009493 | Orphan claim re-pointed Claims processor | CLM-411968 → UHC-35000-43 (Brian Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009494 | Orphan claim re-pointed Claims processor | CLM-400639 → UHC-24189-14 (Russell Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009495 | Orphan claim re-pointed Claims processor | CLM-423827 → UHC-33667-52 (Andrea Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009496 | Orphan claim re-pointed Claims processor | CLM-406520 → UHC-72768-33 (Melissa Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009497 | Orphan claim re-pointed Claims processor | CLM-419852 → UHC-64421-02 (Mason Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009498 | Orphan claim re-pointed Claims processor | CLM-413545 → UHC-69020-57 (Kelly Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009499 | Orphan claim re-pointed Claims processor | CLM-414321 → UHC-24555-87 (Angela Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009500 | Orphan claim re-pointed Claims processor | CLM-415184 → UHC-95783-42 (Lida Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009501 | Orphan claim re-pointed Claims processor | CLM-415921 → UHC-68630-22 (Donna Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009502 | Orphan claim re-pointed Claims processor | CLM-417577 → UHC-96995-64 (Angela Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009503 | Orphan claim re-pointed Claims processor | CLM-400731 → UHC-76291-34 (Jacob Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009504 | Orphan claim re-pointed Claims processor | CLM-400624 → UHC-22020-09 (Harold Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009505 | Orphan claim re-pointed Claims processor | CLM-431899 → UHC-38371-52 (Margaret Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009506 | Orphan claim re-pointed Claims processor | CLM-426935 → UHC-69569-85 (Ashley Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009507 | Orphan claim re-pointed Claims processor | CLM-415415 → UHC-84537-40 (Carolyn Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009508 | Orphan claim re-pointed Claims processor | CLM-422353 → UHC-58969-79 (Marcus Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009509 | Orphan claim re-pointed Claims processor | CLM-423898 → UHC-11485-33 (Mateo Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009510 | Orphan claim re-pointed Claims processor | CLM-419586 → UHC-89576-14 (Karen Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009511 | Orphan claim re-pointed Claims processor | CLM-416802 → UHC-33270-80 (Michelle Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009512 | Orphan claim re-pointed Claims processor | CLM-428552 → UHC-68273-18 (Eugene Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009513 | Orphan claim re-pointed Claims processor | CLM-417490 → UHC-67574-82 (Logan Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009514 | Orphan claim re-pointed Claims processor | CLM-417246 → UHC-66093-90 (Kimberly Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009515 | Orphan claim re-pointed Claims processor | CLM-423807 → UHC-53640-66 (Carlos Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009516 | Orphan claim re-pointed Claims processor | CLM-427532 → UHC-81174-40 (Christian Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009517 | Orphan claim re-pointed Claims processor | CLM-415992 → UHC-73997-97 (Charlotte Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009518 | Orphan claim re-pointed Claims processor | CLM-400148 → UHC-45106-70 (Jennifer Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009519 | Orphan claim re-pointed Claims processor | CLM-423236 → UHC-40992-46 (Diana Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009520 | Orphan claim re-pointed Claims processor | CLM-400676 → UHC-34291-20 (Raymond Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009521 | Orphan claim re-pointed Claims processor | CLM-410246 → UHC-81797-93 (Bradley Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009522 | Orphan claim re-pointed Claims processor | CLM-419977 → UHC-30205-67 (Peter Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009523 | Orphan claim re-pointed Claims processor | CLM-421118 → UHC-33321-26 (Jessica Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009524 | Orphan claim re-pointed Claims processor | CLM-430322 → UHC-75817-92 (Amber McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009525 | Orphan claim re-pointed Claims processor | CLM-408201 → UHC-55258-87 (Theresa Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009526 | Orphan claim re-pointed Claims processor | CLM-416562 → UHC-47259-09 (Priya Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009527 | Orphan claim re-pointed Claims processor | CLM-408987 → UHC-24111-97 (Betty Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009528 | Orphan claim re-pointed Claims processor | CLM-408683 → UHC-31244-35 (Douglas Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009529 | Orphan claim re-pointed Claims processor | CLM-422855 → UHC-21650-45 (Timothy Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009530 | Orphan claim re-pointed Claims processor | CLM-403254 → UHC-29251-65 (Jean Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009531 | Orphan claim re-pointed Claims processor | CLM-412623 → UHC-05005-65 (Vincent George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009532 | Orphan claim re-pointed Claims processor | CLM-414528 → UHC-91573-67 (Bryan Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009533 | Orphan claim re-pointed Claims processor | CLM-410743 → UHC-41204-86 (Gregory Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009534 | Orphan claim re-pointed Claims processor | CLM-405362 → UHC-59196-09 (Brandon Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009535 | Orphan claim re-pointed Claims processor | CLM-423868 → UHC-91604-29 (Mariana Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009536 | Orphan claim re-pointed Claims processor | CLM-418485 → UHC-51877-99 (Ruth Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009537 | Orphan claim re-pointed Claims processor | CLM-415005 → UHC-86062-54 (Laura Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009538 | Orphan claim re-pointed Claims processor | CLM-400262 → UHC-61133-79 (Ronald Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009539 | Orphan claim re-pointed Claims processor | CLM-420234 → UHC-25421-25 (Karen Ruiz) |
| 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.