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-001562 | Orphan claim re-pointed Claims processor | CLM-412316 → UHC-80658-32 (John Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001563 | Orphan claim re-pointed Claims processor | CLM-427026 → UHC-51192-01 (Megan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001564 | Orphan claim re-pointed Claims processor | CLM-425745 → UHC-11038-16 (Li Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001565 | Orphan claim re-pointed Claims processor | CLM-401137 → UHC-27759-35 (Natalie Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001566 | Orphan claim re-pointed Claims processor | CLM-417430 → UHC-97871-08 (Maria Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001567 | Orphan claim re-pointed Claims processor | CLM-421779 → UHC-68512-24 (Rachel Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001568 | Orphan claim re-pointed Claims processor | CLM-403482 → UHC-38295-18 (Nicole Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001569 | Orphan claim re-pointed Claims processor | CLM-418200 → UHC-57655-78 (Laura Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001570 | Orphan claim re-pointed Claims processor | CLM-419890 → UHC-50533-10 (Elijah Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001571 | Orphan claim re-pointed Claims processor | CLM-409058 → UHC-66414-72 (Aisha Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001572 | Orphan claim re-pointed Claims processor | CLM-421412 → UHC-39923-61 (Stephen Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001573 | Orphan claim re-pointed Claims processor | CLM-427736 → UHC-07805-06 (Lucia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001574 | Orphan claim re-pointed Claims processor | CLM-403309 → UHC-36773-55 (Judy Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001575 | Orphan claim re-pointed Claims processor | CLM-410828 → UHC-08400-52 (Justin Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001576 | Orphan claim re-pointed Claims processor | CLM-400234 → UHC-96990-15 (Angela Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001577 | Orphan claim re-pointed Claims processor | CLM-418722 → UHC-11833-22 (Ralph Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001578 | Orphan claim re-pointed Claims processor | CLM-411576 → UHC-66914-34 (Kyle Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001579 | Orphan claim re-pointed Claims processor | CLM-431535 → UHC-98440-07 (Amanda Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001580 | Orphan claim re-pointed Claims processor | CLM-400835 → UHC-82880-52 (Julie Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001581 | Orphan claim re-pointed Claims processor | CLM-402587 → UHC-34799-44 (Jennifer Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001582 | Orphan claim re-pointed Claims processor | CLM-414941 → UHC-74433-78 (Benjamin Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001583 | Orphan claim re-pointed Claims processor | CLM-412479 → UHC-55006-25 (Samuel Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001584 | Orphan claim re-pointed Claims processor | CLM-411960 → UHC-81594-20 (Pamela Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001585 | Orphan claim re-pointed Claims processor | CLM-405970 → UHC-91270-07 (Larry Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001586 | Orphan claim re-pointed Claims processor | CLM-431778 → UHC-23575-96 (Ashley Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001587 | Orphan claim re-pointed Claims processor | CLM-430226 → UHC-66078-28 (Aisha Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001588 | Orphan claim re-pointed Claims processor | CLM-409995 → UHC-15361-56 (Jean Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001589 | Orphan claim re-pointed Claims processor | CLM-429356 → UHC-30144-81 (Janet Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001590 | Orphan claim re-pointed Claims processor | CLM-425526 → UHC-84998-85 (Zachary Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001591 | Orphan claim re-pointed Claims processor | CLM-429259 → UHC-28029-33 (Frank Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001592 | Orphan claim re-pointed Claims processor | CLM-405560 → UHC-90923-96 (Isabella Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001593 | Orphan claim re-pointed Claims processor | CLM-404049 → UHC-76731-09 (Sophia Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001594 | Orphan claim re-pointed Claims processor | CLM-428618 → UHC-59751-23 (Jack Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001595 | Orphan claim re-pointed Claims processor | CLM-427698 → UHC-04644-40 (Sharon Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001596 | Orphan claim re-pointed Claims processor | CLM-419050 → UHC-53279-40 (Jesse Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001597 | Orphan claim re-pointed Claims processor | CLM-409435 → UHC-31790-37 (Evelyn Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001598 | Orphan claim re-pointed Claims processor | CLM-424027 → UHC-57726-03 (Yuki Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001599 | Orphan claim re-pointed Claims processor | CLM-408163 → UHC-68692-47 (Philip Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001600 | Orphan claim re-pointed Claims processor | CLM-431768 → UHC-50152-63 (Hiroshi Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001601 | Orphan claim re-pointed Claims processor | CLM-432393 → UHC-50578-50 (Beverly Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001602 | Orphan claim re-pointed Claims processor | CLM-408855 → UHC-41752-65 (Martha Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001603 | Orphan claim re-pointed Claims processor | CLM-404166 → UHC-64798-78 (Larry Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001604 | Orphan claim re-pointed Claims processor | CLM-401675 → UHC-05909-14 (Donald Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001605 | Orphan claim re-pointed Claims processor | CLM-406970 → UHC-83312-34 (Matthew Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001606 | Orphan claim re-pointed Claims processor | CLM-417174 → UHC-90056-35 (Carolyn Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001607 | Orphan claim re-pointed Claims processor | CLM-405134 → UHC-00613-90 (James Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001608 | Orphan claim re-pointed Claims processor | CLM-409493 → UHC-14810-76 (Nathan Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001609 | Orphan claim re-pointed Claims processor | CLM-406262 → UHC-42998-10 (Larry Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001610 | Orphan claim re-pointed Claims processor | CLM-423308 → UHC-61253-61 (Justin Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001611 | Orphan claim re-pointed Claims processor | CLM-407081 → UHC-49611-17 (Andrew Fisher) |
| 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.