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-001612 | Orphan claim re-pointed Claims processor | CLM-418182 → UHC-20019-45 (Maria Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001613 | Orphan claim re-pointed Claims processor | CLM-423210 → UHC-60287-08 (Elijah Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001614 | Orphan claim re-pointed Claims processor | CLM-421331 → UHC-39834-55 (Jean Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001615 | Orphan claim re-pointed Claims processor | CLM-411924 → UHC-75741-71 (Kimberly Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001616 | Orphan claim re-pointed Claims processor | CLM-419217 → UHC-96383-74 (Jerry Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001617 | Orphan claim re-pointed Claims processor | CLM-430346 → UHC-69597-53 (Hiroshi Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001618 | Orphan claim re-pointed Claims processor | CLM-413745 → UHC-63752-52 (Marcus Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001619 | Orphan claim re-pointed Claims processor | CLM-401160 → UHC-09214-53 (Dorothy Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001620 | Orphan claim re-pointed Claims processor | CLM-406161 → UHC-17519-92 (Noah Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001621 | Orphan claim re-pointed Claims processor | CLM-400801 → UHC-91481-56 (Randy Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001622 | Orphan claim re-pointed Claims processor | CLM-413283 → UHC-75080-03 (Samuel Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001623 | Orphan claim re-pointed Claims processor | CLM-411318 → UHC-59588-79 (Betty Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001624 | Orphan claim re-pointed Claims processor | CLM-412278 → UHC-43012-07 (Terry Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001625 | Orphan claim re-pointed Claims processor | CLM-420707 → UHC-73110-21 (Peter Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001626 | Orphan claim re-pointed Claims processor | CLM-432447 → UHC-08660-19 (Christina Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001627 | Orphan claim re-pointed Claims processor | CLM-429287 → UHC-41416-73 (Bobby Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001628 | Orphan claim re-pointed Claims processor | CLM-425737 → UHC-89369-21 (Arjun Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001629 | Orphan claim re-pointed Claims processor | CLM-404449 → UHC-66696-56 (Justin Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001630 | Orphan claim re-pointed Claims processor | CLM-409829 → UHC-89460-83 (Roger Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001631 | Orphan claim re-pointed Claims processor | CLM-415241 → UHC-34996-49 (Ann Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001632 | Orphan claim re-pointed Claims processor | CLM-430498 → UHC-72190-33 (Ray Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001633 | Orphan claim re-pointed Claims processor | CLM-414272 → UHC-83331-37 (Adam Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001634 | Orphan claim re-pointed Claims processor | CLM-401924 → UHC-30222-34 (Teresa Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001635 | Orphan claim re-pointed Claims processor | CLM-412011 → UHC-70117-04 (Jose Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001636 | Orphan claim re-pointed Claims processor | CLM-407284 → UHC-97077-15 (Dylan Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001637 | Orphan claim re-pointed Claims processor | CLM-413703 → UHC-99637-94 (Carol Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001638 | Orphan claim re-pointed Claims processor | CLM-403756 → UHC-80360-58 (Amy Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001639 | Orphan claim re-pointed Claims processor | CLM-422962 → UHC-18077-63 (Debra Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001640 | Orphan claim re-pointed Claims processor | CLM-409991 → UHC-44921-94 (Mark Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001641 | Orphan claim re-pointed Claims processor | CLM-427622 → UHC-71503-66 (Jose Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001642 | Orphan claim re-pointed Claims processor | CLM-413823 → UHC-28890-43 (Madison Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001643 | Orphan claim re-pointed Claims processor | CLM-430928 → UHC-71924-51 (Jason Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001644 | Orphan claim re-pointed Claims processor | CLM-418000 → UHC-73816-85 (Hiroshi Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001645 | Orphan claim re-pointed Claims processor | CLM-410715 → UHC-43965-26 (Harold Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001646 | Orphan claim re-pointed Claims processor | CLM-410694 → UHC-84665-74 (David Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001647 | Orphan claim re-pointed Claims processor | CLM-425818 → UHC-57021-61 (Christine Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001648 | Orphan claim re-pointed Claims processor | CLM-419940 → UHC-33495-99 (Gloria Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001649 | Orphan claim re-pointed Claims processor | CLM-427386 → UHC-37162-88 (Mei Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001650 | Orphan claim re-pointed Claims processor | CLM-422730 → UHC-11971-67 (Benjamin Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001651 | Orphan claim re-pointed Claims processor | CLM-430974 → UHC-90564-84 (Diane Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001652 | Orphan claim re-pointed Claims processor | CLM-402851 → UHC-16038-21 (Olivia Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001653 | Orphan claim re-pointed Claims processor | CLM-431941 → UHC-90646-41 (Diego Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001654 | Orphan claim re-pointed Claims processor | CLM-429681 → UHC-72843-98 (Cheryl Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001655 | Orphan claim re-pointed Claims processor | CLM-412884 → UHC-31359-39 (Cynthia Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001656 | Orphan claim re-pointed Claims processor | CLM-410307 → UHC-55904-11 (Helen Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001657 | Orphan claim re-pointed Claims processor | CLM-406675 → UHC-36379-12 (William Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001658 | Orphan claim re-pointed Claims processor | CLM-417144 → UHC-10960-04 (Anna Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001659 | Orphan claim re-pointed Claims processor | CLM-407266 → UHC-91645-03 (Julia George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001660 | Orphan claim re-pointed Claims processor | CLM-414396 → UHC-35055-55 (Santiago Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001661 | Orphan claim re-pointed Claims processor | CLM-404060 → UHC-71322-95 (Lauren Wong) |
| 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.