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-021639 | New member onboarding Next-best-action | Donna Willis: enrolled 2026-09-29, no activity yet |
| Proposed | — | ||
| ACT-021640 | New member onboarding Next-best-action | Yuki Mitchell: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-021641 | New member onboarding Next-best-action | Logan Hamilton: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021642 | New member onboarding Next-best-action | Omar Daniels: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-021643 | New member onboarding Next-best-action | Benjamin Hanson: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-021644 | New member onboarding Next-best-action | Kelly Dixon: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021645 | New member onboarding Next-best-action | Philip Shaw: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-021646 | New member onboarding Next-best-action | Evelyn Rjas: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-021647 | New member onboarding Next-best-action | Sofia Scott: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-021648 | New member onboarding Next-best-action | Janice Booyd: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-021649 | New member onboarding Next-best-action | Albert Garza: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-021650 | New member onboarding Next-best-action | Josua Ferguson: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-021651 | New member onboarding Next-best-action | Amber Maldonado: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-021652 | New member onboarding Next-best-action | Ethan Delgado: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-021653 | New member onboarding Next-best-action | Bryan Hudson: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-021654 | New member onboarding Next-best-action | Janice Sanders: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-021655 | New member onboarding Next-best-action | Jeremy Andrews: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-021656 | New member onboarding Next-best-action | Teresa Lopez: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-021657 | New member onboarding Next-best-action | Marcus Johnston: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-021658 | New member onboarding Next-best-action | Ryan Cruz: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-021659 | New member onboarding Next-best-action | Medina Abigail: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-021660 | New member onboarding Next-best-action | Katherine Washington: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-021661 | New member onboarding Next-best-action | Carol Hoffman: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-021662 | New member onboarding Next-best-action | Charlotte Alvarado: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-021663 | New member onboarding Next-best-action | Alan Howell: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-021664 | New member onboarding Next-best-action | Jonathan Franklin: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-021665 | New member onboarding Next-best-action | Julie Evans: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-021666 | New member onboarding Next-best-action | Nicholas Henry: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-001340 | Orphan claim re-pointed Claims processor | CLM-403288 → UHC-81817-78 (Shirley Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001341 | Orphan claim re-pointed Claims processor | CLM-409453 → UHC-06553-73 (Pamela Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001342 | Orphan claim re-pointed Claims processor | CLM-415528 → UHC-11930-34 (Amy Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001343 | Orphan claim re-pointed Claims processor | CLM-414432 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001344 | Orphan claim re-pointed Claims processor | CLM-429901 → UHC-05517-87 (Mark Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001345 | Orphan claim re-pointed Claims processor | CLM-428305 → UHC-63351-43 (Jerry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001346 | Orphan claim re-pointed Claims processor | CLM-400406 → UHC-06862-81 (Aaron Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001347 | Orphan claim re-pointed Claims processor | CLM-421183 → UHC-18725-71 (Gary Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001348 | Orphan claim re-pointed Claims processor | CLM-427685 → UHC-22892-68 (Jesse Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001349 | Orphan claim re-pointed Claims processor | CLM-420295 → UHC-17734-66 (Susan Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001350 | Orphan claim re-pointed Claims processor | CLM-416029 → UHC-03400-57 (Lori Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001351 | Orphan claim re-pointed Claims processor | CLM-423678 → UHC-38974-87 (Adam Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001352 | Orphan claim re-pointed Claims processor | CLM-407989 → UHC-37140-99 (Camila Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001353 | Orphan claim re-pointed Claims processor | CLM-402703 → UHC-55663-84 (Donna Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001354 | Orphan claim re-pointed Claims processor | CLM-407140 → UHC-71190-27 (Alice Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001355 | Orphan claim re-pointed Claims processor | CLM-419476 → UHC-37209-76 (Olivia Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001356 | Orphan claim re-pointed Claims processor | CLM-411580 → UHC-39070-93 (Samuel Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001357 | Orphan claim re-pointed Claims processor | CLM-401561 → UHC-59698-55 (Jessica Elllis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001358 | Orphan claim re-pointed Claims processor | CLM-418488 → UHC-29960-66 (Julia Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001359 | Orphan claim re-pointed Claims processor | CLM-423756 → UHC-90029-18 (Bradley Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001360 | Orphan claim re-pointed Claims processor | CLM-404732 → UHC-96679-77 (Ann Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001361 | Orphan claim re-pointed Claims processor | CLM-424375 → UHC-86900-82 (Bowman Bowman) |
| 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.