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-001712 | Orphan claim re-pointed Claims processor | CLM-406752 → UHC-39058-94 (Maria Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001713 | Orphan claim re-pointed Claims processor | CLM-430724 → UHC-62782-53 (Mateo Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001714 | Orphan claim re-pointed Claims processor | CLM-412820 → UHC-85614-59 (Hiroshi Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001715 | Orphan claim re-pointed Claims processor | CLM-429986 → UHC-06749-57 (Raymond Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001716 | Orphan claim re-pointed Claims processor | CLM-402368 → UHC-43478-17 (Charles Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001717 | Orphan claim re-pointed Claims processor | CLM-428852 → UHC-57396-21 (Deborah Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001718 | Orphan claim re-pointed Claims processor | CLM-422357 → UHC-60709-46 (Bruce Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001719 | Orphan claim re-pointed Claims processor | CLM-432226 → UHC-99920-82 (Nicole Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001720 | Orphan claim re-pointed Claims processor | CLM-409300 → UHC-88385-96 (Raymond Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001721 | Orphan claim re-pointed Claims processor | CLM-417721 → UHC-73218-61 (Joseph Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001722 | Orphan claim re-pointed Claims processor | CLM-402366 → UHC-92649-44 (Roger Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001723 | Orphan claim re-pointed Claims processor | CLM-424832 → UHC-65868-91 (Joe Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001724 | Orphan claim re-pointed Claims processor | CLM-407598 → UHC-74481-70 (Beverly Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001725 | Orphan claim re-pointed Claims processor | CLM-414802 → UHC-71698-36 (John Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001726 | Orphan claim re-pointed Claims processor | CLM-416689 → UHC-57264-54 (Heatheer George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001727 | Orphan claim re-pointed Claims processor | CLM-428585 → UHC-76545-20 (Wayne Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001728 | Orphan claim re-pointed Claims processor | CLM-419435 → UHC-97068-21 (Jonathan Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001729 | Orphan claim re-pointed Claims processor | CLM-411499 → UHC-74308-55 (Jack Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001730 | Orphan claim re-pointed Claims processor | CLM-416785 → UHC-71651-40 (Vincent Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001731 | Orphan claim re-pointed Claims processor | CLM-416917 → UHC-34595-03 (Carol Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001732 | Orphan claim re-pointed Claims processor | CLM-400462 → UHC-62709-80 (David Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001733 | Orphan claim re-pointed Claims processor | CLM-401089 → UHC-64189-42 (Amy Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001734 | Orphan claim re-pointed Claims processor | CLM-428158 → UHC-56916-28 (Logan Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001735 | Orphan claim re-pointed Claims processor | CLM-403812 → UHC-53289-31 (Deborah Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001736 | Orphan claim re-pointed Claims processor | CLM-423017 → UHC-07292-09 (Jen Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001737 | Orphan claim re-pointed Claims processor | CLM-412840 → UHC-15044-36 (Ryan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001738 | Orphan claim re-pointed Claims processor | CLM-429110 → UHC-44226-46 (Christopher Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001739 | Orphan claim re-pointed Claims processor | CLM-405988 → UHC-80866-65 (Diego Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001740 | Orphan claim re-pointed Claims processor | CLM-430660 → UHC-26690-16 (Judith Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001741 | Orphan claim re-pointed Claims processor | CLM-408005 → UHC-99324-88 (Amy Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001742 | Orphan claim re-pointed Claims processor | CLM-402499 → UHC-34796-81 (Brandon Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001743 | Orphan claim re-pointed Claims processor | CLM-409918 → UHC-51890-28 (Gerald Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001744 | Orphan claim re-pointed Claims processor | CLM-406018 → UHC-73426-48 (Kayla Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001745 | Orphan claim re-pointed Claims processor | CLM-404641 → UHC-56584-90 (Debra Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001746 | Orphan claim re-pointed Claims processor | CLM-407283 → UHC-97077-15 (Dylan Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001747 | Orphan claim re-pointed Claims processor | CLM-404729 → UHC-29195-03 (Jesse Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001748 | Orphan claim re-pointed Claims processor | CLM-415392 → UHC-75813-69 (Mariana Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001749 | Orphan claim re-pointed Claims processor | CLM-429098 → UHC-37730-93 (Emily Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001750 | Orphan claim re-pointed Claims processor | CLM-410897 → UHC-14493-37 (Cheryl Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001751 | Orphan claim re-pointed Claims processor | CLM-413707 → UHC-47164-26 (Santiago Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001752 | Orphan claim re-pointed Claims processor | CLM-427249 → UHC-02784-11 (Joshua Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001753 | Orphan claim re-pointed Claims processor | CLM-412951 → UHC-61964-52 (Jennifer Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001754 | Orphan claim re-pointed Claims processor | CLM-404600 → UHC-47652-65 (Deborah Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001755 | Orphan claim re-pointed Claims processor | CLM-401639 → UHC-90696-28 (Charles Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001756 | Orphan claim re-pointed Claims processor | CLM-418267 → UHC-79734-63 (Lucia Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001757 | Orphan claim re-pointed Claims processor | CLM-430201 → UHC-22797-90 (Philip Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001758 | Orphan claim re-pointed Claims processor | CLM-424354 → UHC-11129-89 (Henry Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001759 | Orphan claim re-pointed Claims processor | CLM-415467 → UHC-89857-59 (Zachary Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001760 | Orphan claim re-pointed Claims processor | CLM-430365 → UHC-56559-86 (Andrea Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001761 | Orphan claim re-pointed Claims processor | CLM-411702 → UHC-00977-64 (Wei Robinson) |
| 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.