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-001412 | Orphan claim re-pointed Claims processor | CLM-413269 → UHC-33504-82 (Laura Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001413 | Orphan claim re-pointed Claims processor | CLM-426158 → UHC-53548-27 (Roy Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001414 | Orphan claim re-pointed Claims processor | CLM-428579 → UHC-89148-48 (Ana Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001415 | Orphan claim re-pointed Claims processor | CLM-426562 → UHC-77048-48 (Scott Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001416 | Orphan claim re-pointed Claims processor | CLM-414872 → UHC-90127-83 (Elizabeth George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001417 | Orphan claim re-pointed Claims processor | CLM-429527 → UHC-29333-35 (Frances Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001418 | Orphan claim re-pointed Claims processor | CLM-412345 → UHC-53627-10 (Frances Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001419 | Orphan claim re-pointed Claims processor | CLM-425021 → UHC-39990-48 (Maria Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001420 | Orphan claim re-pointed Claims processor | CLM-417865 → UHC-29559-72 (Jacqueline Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001421 | Orphan claim re-pointed Claims processor | CLM-419195 → UHC-10163-44 (Bruce Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001422 | Orphan claim re-pointed Claims processor | CLM-405836 → UHC-04169-42 (Vincent Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001423 | Orphan claim re-pointed Claims processor | CLM-405095 → UHC-32928-11 (Valentina Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001424 | Orphan claim re-pointed Claims processor | CLM-425514 → UHC-18011-83 (Walter Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001425 | Orphan claim re-pointed Claims processor | CLM-415092 → UHC-18514-12 (Daniel Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001426 | Orphan claim re-pointed Claims processor | CLM-408551 → UHC-20476-18 (Mariana Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001427 | Orphan claim re-pointed Claims processor | CLM-418604 → UHC-12777-98 (Cynthia Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001428 | Orphan claim re-pointed Claims processor | CLM-430483 → UHC-72655-13 (George Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001429 | Orphan claim re-pointed Claims processor | CLM-426023 → UHC-14666-69 (Dorothy Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001430 | Orphan claim re-pointed Claims processor | CLM-412049 → UHC-12730-25 (Kevin Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001431 | Orphan claim re-pointed Claims processor | CLM-407726 → UHC-23060-35 (Billy Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001432 | Orphan claim re-pointed Claims processor | CLM-402410 → UHC-12831-60 (Debra Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001433 | Orphan claim re-pointed Claims processor | CLM-407681 → UHC-74416-41 (Megan Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001434 | Orphan claim re-pointed Claims processor | CLM-405694 → UHC-71216-93 (Kenneth Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001435 | Orphan claim re-pointed Claims processor | CLM-416805 → UHC-34558-20 (Aaron Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001436 | Orphan claim re-pointed Claims processor | CLM-420992 → UHC-96647-42 (Doris Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001437 | Orphan claim re-pointed Claims processor | CLM-429888 → UHC-34288-51 (Alan Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001438 | Orphan claim re-pointed Claims processor | CLM-430004 → UHC-11306-08 (Yuki Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001439 | Orphan claim re-pointed Claims processor | CLM-414891 → UHC-48337-47 (David Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001440 | Orphan claim re-pointed Claims processor | CLM-405033 → UHC-92637-64 (Christopher Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001441 | Orphan claim re-pointed Claims processor | CLM-403824 → UHC-40594-68 (Scott Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001442 | Orphan claim re-pointed Claims processor | CLM-428467 → UHC-23896-63 (Danielle Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001443 | Orphan claim re-pointed Claims processor | CLM-429220 → UHC-69901-39 (Aisha Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001444 | Orphan claim re-pointed Claims processor | CLM-403173 → UHC-40061-23 (Stephanie Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001445 | Orphan claim re-pointed Claims processor | CLM-424244 → UHC-82481-95 (Judith Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001446 | Orphan claim re-pointed Claims processor | CLM-414278 → UHC-26709-92 (Zachary Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001447 | Orphan claim re-pointed Claims processor | CLM-426166 → UHC-96761-53 (Jeremy Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001448 | Orphan claim re-pointed Claims processor | CLM-411191 → UHC-33676-78 (Brandon Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001449 | Orphan claim re-pointed Claims processor | CLM-423971 → UHC-07728-57 (Jennifer Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001450 | Orphan claim re-pointed Claims processor | CLM-415637 → UHC-06408-75 (Dylan Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001451 | Orphan claim re-pointed Claims processor | CLM-405226 → UHC-96362-36 (Kayla Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001452 | Orphan claim re-pointed Claims processor | CLM-406470 → UHC-84368-17 (Stephen Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001453 | Orphan claim re-pointed Claims processor | CLM-415628 → UHC-49054-08 (Martha Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001454 | Orphan claim re-pointed Claims processor | CLM-419094 → UHC-63825-95 (Helen Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001455 | Orphan claim re-pointed Claims processor | CLM-409314 → UHC-16964-87 (Douglas Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001456 | Orphan claim re-pointed Claims processor | CLM-419299 → UHC-12076-16 (Isabella Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001457 | Orphan claim re-pointed Claims processor | CLM-427508 → UHC-27327-14 (Brian Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001458 | Orphan claim re-pointed Claims processor | CLM-428285 → UHC-09268-29 (Jessica Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001459 | Orphan claim re-pointed Claims processor | CLM-432016 → UHC-58249-92 (Bradley Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001460 | Orphan claim re-pointed Claims processor | CLM-421596 → UHC-83597-11 (Terry Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001461 | Orphan claim re-pointed Claims processor | CLM-415906 → UHC-46707-26 (Nathan Campbell) |
| 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.