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-009590 | Orphan claim re-pointed Claims processor | CLM-422998 → UHC-92316-19 (Patricia Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009591 | Orphan claim re-pointed Claims processor | CLM-414395 → UHC-42867-23 (Vincent Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009592 | Orphan claim re-pointed Claims processor | CLM-410603 → UHC-24627-62 (Janet Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009593 | Orphan claim re-pointed Claims processor | CLM-410187 → UHC-43293-68 (Kyle Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009594 | Orphan claim re-pointed Claims processor | CLM-413451 → UHC-10855-85 (Samantha Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009595 | Orphan claim re-pointed Claims processor | CLM-425662 → UHC-15001-22 (Benjamin Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009596 | Orphan claim re-pointed Claims processor | CLM-422089 → UHC-67772-21 (Aisha Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009597 | Orphan claim re-pointed Claims processor | CLM-423268 → UHC-79108-37 (Stephen Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009598 | Orphan claim re-pointed Claims processor | CLM-410889 → UHC-91757-89 (Katherine Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009599 | Orphan claim re-pointed Claims processor | CLM-417654 → UHC-89409-50 (Roy Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009600 | Orphan claim re-pointed Claims processor | CLM-406736 → UHC-53310-24 (Christian Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009601 | Orphan claim re-pointed Claims processor | CLM-431356 → UHC-83163-59 (Elizabeth Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009602 | Orphan claim re-pointed Claims processor | CLM-414968 → UHC-50709-36 (Henry Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009603 | Orphan claim re-pointed Claims processor | CLM-421176 → UHC-73240-85 (Willie Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009604 | Orphan claim re-pointed Claims processor | CLM-430604 → UHC-82354-43 (Elizabeth Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009605 | Orphan claim re-pointed Claims processor | CLM-423946 → UHC-49852-21 (Sandra Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009606 | Orphan claim re-pointed Claims processor | CLM-427660 → UHC-38301-28 (Mason Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009607 | Orphan claim re-pointed Claims processor | CLM-404508 → UHC-98038-11 (Eugene Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009608 | Orphan claim re-pointed Claims processor | CLM-408563 → UHC-76825-64 (Carol Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009609 | Orphan claim re-pointed Claims processor | CLM-400247 → UHC-08559-01 (Jonathan Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009610 | Orphan claim re-pointed Claims processor | CLM-428113 → UHC-75946-86 (Janice Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009611 | Orphan claim re-pointed Claims processor | CLM-421348 → UHC-21833-47 (Michelle Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009612 | Orphan claim re-pointed Claims processor | CLM-401629 → UHC-19610-84 (Jimmy Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009613 | Orphan claim re-pointed Claims processor | CLM-416748 → UHC-01311-77 (Lauren Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009614 | Orphan claim re-pointed Claims processor | CLM-425867 → UHC-28110-84 (Roger Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009615 | Orphan claim re-pointed Claims processor | CLM-432421 → UHC-69967-07 (Kayla Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009616 | Orphan claim re-pointed Claims processor | CLM-403073 → UHC-45695-22 (Diego West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009617 | Orphan claim re-pointed Claims processor | CLM-400972 → UHC-17854-92 (Beverly Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009618 | Orphan claim re-pointed Claims processor | CLM-420085 → UHC-40806-34 (Betty Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009619 | Orphan claim re-pointed Claims processor | CLM-401245 → UHC-50329-53 (Aisha Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009620 | Orphan claim re-pointed Claims processor | CLM-426319 → UHC-79699-27 (Abigail Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009621 | Orphan claim re-pointed Claims processor | CLM-431808 → UHC-50109-81 (Beverly Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009622 | Orphan claim re-pointed Claims processor | CLM-407923 → UHC-95936-49 (Donald Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009623 | Orphan claim re-pointed Claims processor | CLM-419461 → UHC-48943-31 (Robert Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009624 | Orphan claim re-pointed Claims processor | CLM-409278 → UHC-91114-24 (Jason Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009625 | Orphan claim re-pointed Claims processor | CLM-431636 → UHC-70015-67 (Douglas Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009626 | Orphan claim re-pointed Claims processor | CLM-428812 → UHC-19577-66 (Ralph Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009627 | Orphan claim re-pointed Claims processor | CLM-410303 → UHC-33289-65 (Edward Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009628 | Orphan claim re-pointed Claims processor | CLM-418440 → UHC-44478-63 (Megan Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009629 | Orphan claim re-pointed Claims processor | CLM-406712 → UHC-65449-18 (Jessica Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009630 | Orphan claim re-pointed Claims processor | CLM-430157 → UHC-68634-52 (David Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009631 | Orphan claim re-pointed Claims processor | CLM-413362 → UHC-30684-46 (Ashley Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009632 | Orphan claim re-pointed Claims processor | CLM-422608 → UHC-20775-72 (Jacqueline Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009633 | Orphan claim re-pointed Claims processor | CLM-417069 → UHC-73875-97 (Sara Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009634 | Orphan claim re-pointed Claims processor | CLM-420327 → UHC-47052-61 (Kyle Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009635 | Orphan claim re-pointed Claims processor | CLM-418109 → UHC-29550-43 (Mason Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009636 | Orphan claim re-pointed Claims processor | CLM-428770 → UHC-59697-99 (Sandra Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009637 | Orphan claim re-pointed Claims processor | CLM-420765 → UHC-28186-60 (Joyce Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009638 | Orphan claim re-pointed Claims processor | CLM-429102 → UHC-75690-49 (Brenda Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009639 | Orphan claim re-pointed Claims processor | CLM-430052 → UHC-99220-13 (Julia Coleman) |
| 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.