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-001362 | Orphan claim re-pointed Claims processor | CLM-412946 → UHC-66079-97 (Kyle Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001363 | Orphan claim re-pointed Claims processor | CLM-419172 → UHC-76600-57 (Frank Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001364 | Orphan claim re-pointed Claims processor | CLM-403733 → UHC-96431-19 (Kathryn Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001365 | Orphan claim re-pointed Claims processor | CLM-404402 → UHC-87281-93 (Lisa Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001366 | Orphan claim re-pointed Claims processor | CLM-407293 → UHC-64583-03 (Kimberly White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001367 | Orphan claim re-pointed Claims processor | CLM-411602 → UHC-53647-10 (Amanda Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001368 | Orphan claim re-pointed Claims processor | CLM-428002 → UHC-38530-83 (Helen Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001369 | Orphan claim re-pointed Claims processor | CLM-405400 → UHC-42573-34 (Marilyn Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001370 | Orphan claim re-pointed Claims processor | CLM-408369 → UHC-54625-23 (Mason Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001371 | Orphan claim re-pointed Claims processor | CLM-400741 → UHC-19865-62 (Adam Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001372 | Orphan claim re-pointed Claims processor | CLM-410015 → UHC-48577-49 (Noah Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001373 | Orphan claim re-pointed Claims processor | CLM-428649 → UHC-61970-31 (Mason Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001374 | Orphan claim re-pointed Claims processor | CLM-416854 → UHC-92808-15 (Jeffrey Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001375 | Orphan claim re-pointed Claims processor | CLM-408400 → UHC-92935-47 (Anthony Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001376 | Orphan claim re-pointed Claims processor | CLM-406632 → UHC-85810-37 (Joe Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001377 | Orphan claim re-pointed Claims processor | CLM-409676 → UHC-56059-24 (Margaret Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001378 | Orphan claim re-pointed Claims processor | CLM-422325 → UHC-48780-72 (Lawrence Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001379 | Orphan claim re-pointed Claims processor | CLM-421134 → UHC-72250-82 (Amber Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001380 | Orphan claim re-pointed Claims processor | CLM-409693 → UHC-54667-79 (Christian Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001381 | Orphan claim re-pointed Claims processor | CLM-408783 → UHC-30243-38 (Eugene Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001382 | Orphan claim re-pointed Claims processor | CLM-403734 → UHC-78358-58 (Gabriel Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001383 | Orphan claim re-pointed Claims processor | CLM-403786 → UHC-28452-62 (Walter Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001384 | Orphan claim re-pointed Claims processor | CLM-416622 → UHC-22905-01 (Wayne Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001385 | Orphan claim re-pointed Claims processor | CLM-415138 → UHC-25372-81 (Mei Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001386 | Orphan claim re-pointed Claims processor | CLM-413215 → UHC-76989-44 (Albert Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001387 | Orphan claim re-pointed Claims processor | CLM-401686 → UHC-16393-73 (Bryan Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001388 | Orphan claim re-pointed Claims processor | CLM-414628 → UHC-70988-35 (Alan Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001389 | Orphan claim re-pointed Claims processor | CLM-412467 → UHC-25813-01 (Alexis Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001390 | Orphan claim re-pointed Claims processor | CLM-425378 → UHC-65487-82 (Philip Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001391 | Orphan claim re-pointed Claims processor | CLM-420679 → UHC-21383-58 (Davis Deborah) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001392 | Orphan claim re-pointed Claims processor | CLM-412033 → UHC-80619-64 (Samuel Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001393 | Orphan claim re-pointed Claims processor | CLM-432325 → UHC-22950-87 (Ruth Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001394 | Orphan claim re-pointed Claims processor | CLM-420751 → UHC-97448-63 (Cheryl Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001395 | Orphan claim re-pointed Claims processor | CLM-430778 → UHC-14259-82 (Katherine Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001396 | Orphan claim re-pointed Claims processor | CLM-424081 → UHC-77158-63 (Aaron Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001397 | Orphan claim re-pointed Claims processor | CLM-429999 → UHC-04417-79 (Daniel Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001398 | Orphan claim re-pointed Claims processor | CLM-406486 → UHC-47566-06 (Ralph Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001399 | Orphan claim re-pointed Claims processor | CLM-420956 → UHC-08680-52 (Brian Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001400 | Orphan claim re-pointed Claims processor | CLM-426687 → UHC-49985-38 (Frances Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001401 | Orphan claim re-pointed Claims processor | CLM-415107 → UHC-64207-18 (Emma White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001402 | Orphan claim re-pointed Claims processor | CLM-409359 → UHC-34135-53 (Susan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001403 | Orphan claim re-pointed Claims processor | CLM-407126 → UHC-63084-83 (Valentina Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001404 | Orphan claim re-pointed Claims processor | CLM-428226 → UHC-66979-80 (Joan Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001405 | Orphan claim re-pointed Claims processor | CLM-417452 → UHC-11876-86 (Rachel Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001406 | Orphan claim re-pointed Claims processor | CLM-427901 → UHC-83530-31 (Keith Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001407 | Orphan claim re-pointed Claims processor | CLM-413519 → UHC-29020-28 (Richard Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001408 | Orphan claim re-pointed Claims processor | CLM-413625 → UHC-21997-61 (Eric Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001409 | Orphan claim re-pointed Claims processor | CLM-404032 → UHC-10810-94 (Kyle Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001410 | Orphan claim re-pointed Claims processor | CLM-412954 → UHC-34219-67 (Rachel Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001411 | Orphan claim re-pointed Claims processor | CLM-409018 → UHC-99969-24 (Arjun Flores) |
| 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.