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-009940 | Orphan claim re-pointed Claims processor | CLM-413688 → UHC-35596-29 (Anthony Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009941 | Orphan claim re-pointed Claims processor | CLM-424232 → UHC-82341-82 (Stephanie Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009942 | Orphan claim re-pointed Claims processor | CLM-406881 → UHC-80381-30 (Maria Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009943 | Orphan claim re-pointed Claims processor | CLM-420014 → UHC-17911-64 (Terry Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009944 | Orphan claim re-pointed Claims processor | CLM-404206 → UHC-81221-67 (Kevin Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009945 | Orphan claim re-pointed Claims processor | CLM-407083 → UHC-77574-52 (Bryan Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009946 | Orphan claim re-pointed Claims processor | CLM-402792 → UHC-16351-42 (Daniel Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009947 | Orphan claim re-pointed Claims processor | CLM-424725 → UHC-64857-05 (Jerry Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009948 | Orphan claim re-pointed Claims processor | CLM-411000 → UHC-52155-54 (Scott Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009949 | Orphan claim re-pointed Claims processor | CLM-428170 → UHC-84075-27 (Kevin Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009950 | Orphan claim re-pointed Claims processor | CLM-409735 → UHC-89299-06 (George Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009951 | Orphan claim re-pointed Claims processor | CLM-414676 → UHC-91234-26 (Noah Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009952 | Orphan claim re-pointed Claims processor | CLM-414093 → UHC-58469-79 (Mateo Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009953 | Orphan claim re-pointed Claims processor | CLM-417447 → UHC-44662-69 (Kathy Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009954 | Orphan claim re-pointed Claims processor | CLM-419952 → UHC-94539-95 (Sofia Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009955 | Orphan claim re-pointed Claims processor | CLM-413380 → UHC-92375-65 (Olivia Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009956 | Orphan claim re-pointed Claims processor | CLM-403428 → UHC-86878-50 (Aisha Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009957 | Orphan claim re-pointed Claims processor | CLM-400820 → UHC-10408-31 (Sarah Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009958 | Orphan claim re-pointed Claims processor | CLM-424758 → UHC-54543-72 (Thomas Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009959 | Orphan claim re-pointed Claims processor | CLM-401346 → UHC-46711-68 (Vincent Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009960 | Orphan claim re-pointed Claims processor | CLM-425744 → UHC-82572-04 (Mrtha Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009961 | Orphan claim re-pointed Claims processor | CLM-402322 → UHC-57630-65 (Laura Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009962 | Orphan claim re-pointed Claims processor | CLM-406570 → UHC-69881-24 (Jean Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009963 | Orphan claim re-pointed Claims processor | CLM-428088 → UHC-01332-33 (Kimberly Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009964 | Orphan claim re-pointed Claims processor | CLM-421715 → UHC-62139-96 (Philip Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009965 | Orphan claim re-pointed Claims processor | CLM-410147 → UHC-88927-95 (Evelyn Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009966 | Orphan claim re-pointed Claims processor | CLM-432454 → UHC-56127-37 (Douglas Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009967 | Orphan claim re-pointed Claims processor | CLM-414480 → UHC-97693-66 (Bruce Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009968 | Orphan claim re-pointed Claims processor | CLM-404751 → UHC-91664-02 (Nicole Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009969 | Orphan claim re-pointed Claims processor | CLM-423258 → UHC-59331-75 (Mark Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009970 | Orphan claim re-pointed Claims processor | CLM-428196 → UHC-39155-95 (Gary Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009971 | Orphan claim re-pointed Claims processor | CLM-413709 → UHC-47164-26 (Santiago Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009972 | Orphan claim re-pointed Claims processor | CLM-402056 → UHC-32319-15 (Walter Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009973 | Orphan claim re-pointed Claims processor | CLM-414167 → UHC-04085-61 (Jessica Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009974 | Orphan claim re-pointed Claims processor | CLM-428468 → UHC-12498-22 (Luis Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009975 | Orphan claim re-pointed Claims processor | CLM-414913 → UHC-89766-39 (Dennis Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009976 | Orphan claim re-pointed Claims processor | CLM-420128 → UHC-35459-02 (Scott Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009977 | Orphan claim re-pointed Claims processor | CLM-420971 → UHC-45710-24 (Brittany Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009978 | Orphan claim re-pointed Claims processor | CLM-423857 → UHC-72094-54 (Jacob Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009979 | Orphan claim re-pointed Claims processor | CLM-410054 → UHC-25946-28 (Shirley George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009980 | Orphan claim re-pointed Claims processor | CLM-412020 → UHC-63709-83 (Timothy Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009981 | Orphan claim re-pointed Claims processor | CLM-421031 → UHC-81359-04 (Ruth Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009982 | Orphan claim re-pointed Claims processor | CLM-416722 → UHC-97409-85 (Brittany Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009983 | Orphan claim re-pointed Claims processor | CLM-426065 → UHC-71376-90 (Carolyn Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009984 | Orphan claim re-pointed Claims processor | CLM-410103 → UHC-09369-39 (Joseph Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009985 | Orphan claim re-pointed Claims processor | CLM-431855 → UHC-47672-96 (Mateo Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009986 | Orphan claim re-pointed Claims processor | CLM-415446 → UHC-31370-36 (Helen Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009987 | Orphan claim re-pointed Claims processor | CLM-419059 → UHC-38948-17 (Anthony Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009988 | Orphan claim re-pointed Claims processor | CLM-408814 → UHC-84410-24 (Victoria Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009989 | Orphan claim re-pointed Claims processor | CLM-426098 → UHC-41914-44 (Grace Contreras) |
| 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.