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-001462 | Orphan claim re-pointed Claims processor | CLM-401719 → UHC-60493-89 (Camila James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001463 | Orphan claim re-pointed Claims processor | CLM-432014 → UHC-17803-51 (Arjun Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001464 | Orphan claim re-pointed Claims processor | CLM-401595 → UHC-08965-17 (Melissa Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001465 | Orphan claim re-pointed Claims processor | CLM-411411 → UHC-91238-92 (Kelly Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001466 | Orphan claim re-pointed Claims processor | CLM-401715 → UHC-52048-24 (Andrea Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001467 | Orphan claim re-pointed Claims processor | CLM-405794 → UHC-49058-08 (Nathan Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001468 | Orphan claim re-pointed Claims processor | CLM-429786 → UHC-38315-81 (Heather Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001469 | Orphan claim re-pointed Claims processor | CLM-422541 → UHC-00344-49 (Ralph Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001470 | Orphan claim re-pointed Claims processor | CLM-422850 → UHC-50392-85 (George Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001471 | Orphan claim re-pointed Claims processor | CLM-423601 → UHC-10065-30 (Aaron Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001472 | Orphan claim re-pointed Claims processor | CLM-429059 → UHC-69955-67 (Arjun Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001473 | Orphan claim re-pointed Claims processor | CLM-404214 → UHC-78491-23 (Janice Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001474 | Orphan claim re-pointed Claims processor | CLM-407418 → UHC-15937-04 (Rachel Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001475 | Orphan claim re-pointed Claims processor | CLM-412200 → UHC-60598-92 (Karen Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001476 | Orphan claim re-pointed Claims processor | CLM-417592 → UHC-95805-53 (Dylan Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001477 | Orphan claim re-pointed Claims processor | CLM-408187 → UHC-93294-76 (Abby Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001478 | Orphan claim re-pointed Claims processor | CLM-420702 → UHC-72049-97 (Lauren Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001479 | Orphan claim re-pointed Claims processor | CLM-432670 → UHC-92058-49 (Teresa Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001480 | Orphan claim re-pointed Claims processor | CLM-410236 → UHC-88130-96 (Sarah Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001481 | Orphan claim re-pointed Claims processor | CLM-409280 → UHC-62154-95 (Gloria Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001482 | Orphan claim re-pointed Claims processor | CLM-404652 → UHC-77455-70 (Hannah Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001483 | Orphan claim re-pointed Claims processor | CLM-431867 → UHC-08149-84 (Ronald Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001484 | Orphan claim re-pointed Claims processor | CLM-407118 → UHC-83991-66 (Gloria Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001485 | Orphan claim re-pointed Claims processor | CLM-409798 → UHC-10790-41 (Justin Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001486 | Orphan claim re-pointed Claims processor | CLM-414709 → UHC-31793-33 (Tyler Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001487 | Orphan claim re-pointed Claims processor | CLM-428731 → UHC-63032-05 (Julie Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001488 | Orphan claim re-pointed Claims processor | CLM-401993 → UHC-64409-56 (Alexis Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001489 | Orphan claim re-pointed Claims processor | CLM-404568 → UHC-79224-34 (Lisa Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001490 | Orphan claim re-pointed Claims processor | CLM-410279 → UHC-87261-18 (Angela Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001491 | Orphan claim re-pointed Claims processor | CLM-410099 → UHC-54765-40 (Rachel Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001492 | Orphan claim re-pointed Claims processor | CLM-427241 → UHC-66465-99 (Juan Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001493 | Orphan claim re-pointed Claims processor | CLM-423343 → UHC-54680-35 (Amy Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001494 | Orphan claim re-pointed Claims processor | CLM-410003 → UHC-95791-99 (Denise Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001495 | Orphan claim re-pointed Claims processor | CLM-417054 → UHC-33148-70 (Roger Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001496 | Orphan claim re-pointed Claims processor | CLM-425708 → UHC-50017-11 (Natalie Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001497 | Orphan claim re-pointed Claims processor | CLM-407214 → UHC-59562-45 (Kimberly Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001498 | Orphan claim re-pointed Claims processor | CLM-424932 → UHC-70588-83 (Mei Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001499 | Orphan claim re-pointed Claims processor | CLM-407731 → UHC-35803-15 (Beverly Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001500 | Orphan claim re-pointed Claims processor | CLM-417254 → UHC-90619-60 (Jerry Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001501 | Orphan claim re-pointed Claims processor | CLM-400428 → UHC-63000-58 (Jeremy Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001502 | Orphan claim re-pointed Claims processor | CLM-405346 → UHC-38921-20 (Bruce Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001503 | Orphan claim re-pointed Claims processor | CLM-424422 → UHC-41546-10 (Dorothy Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001504 | Orphan claim re-pointed Claims processor | CLM-429864 → UHC-40656-73 (Aisha Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001505 | Orphan claim re-pointed Claims processor | CLM-418030 → UHC-70211-77 (Kyle Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001506 | Orphan claim re-pointed Claims processor | CLM-424246 → UHC-28620-79 (Katherine Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001507 | Orphan claim re-pointed Claims processor | CLM-403801 → UHC-30857-34 (Frances Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001508 | Orphan claim re-pointed Claims processor | CLM-422040 → UHC-30949-43 (Patrick Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001509 | Orphan claim re-pointed Claims processor | CLM-418957 → UHC-96268-40 (Vincent Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001510 | Orphan claim re-pointed Claims processor | CLM-424267 → UHC-58851-08 (Jack Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001511 | Orphan claim re-pointed Claims processor | CLM-421836 → UHC-25678-83 (Sandra Franklin) |
| 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.