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-009990 | Orphan claim re-pointed Claims processor | CLM-411682 → UHC-38738-20 (Barbara Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009991 | Orphan claim re-pointed Claims processor | CLM-425104 → UHC-85724-40 (Mark Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009992 | Orphan claim re-pointed Claims processor | CLM-404405 → UHC-17326-95 (Rachel Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009993 | Orphan claim re-pointed Claims processor | CLM-403528 → UHC-22088-39 (Maria Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009994 | Orphan claim re-pointed Claims processor | CLM-426239 → UHC-71063-24 (David Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009995 | Orphan claim re-pointed Claims processor | CLM-405025 → UHC-16902-14 (Christine Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009996 | Orphan claim re-pointed Claims processor | CLM-406767 → UHC-10300-72 (Charlotte Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009997 | Orphan claim re-pointed Claims processor | CLM-416531 → UHC-69988-34 (Frances Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009998 | Orphan claim re-pointed Claims processor | CLM-424761 → UHC-28956-10 (Shirley Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009999 | Orphan claim re-pointed Claims processor | CLM-429463 → UHC-65252-88 (Rebecca Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010000 | Orphan claim re-pointed Claims processor | CLM-432061 → UHC-20090-95 (Carl Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010001 | Orphan claim re-pointed Claims processor | CLM-420050 → UHC-40324-56 (Joyce Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010002 | Orphan claim re-pointed Claims processor | CLM-424186 → UHC-21057-88 (Cheryl Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010003 | Orphan claim re-pointed Claims processor | CLM-421226 → UHC-02734-71 (Joan Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010004 | Orphan claim re-pointed Claims processor | CLM-423776 → UHC-59096-88 (Douglas Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010005 | Orphan claim re-pointed Claims processor | CLM-427989 → UHC-92885-35 (Sharon Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010006 | Orphan claim re-pointed Claims processor | CLM-428814 → UHC-08557-91 (Betty Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010007 | Orphan claim re-pointed Claims processor | CLM-431277 → UHC-05205-98 (Nicholas Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010008 | Orphan claim re-pointed Claims processor | CLM-410586 → UHC-13378-62 (Denise Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010009 | Orphan claim re-pointed Claims processor | CLM-425428 → UHC-84466-70 (Sharon Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010010 | Orphan claim re-pointed Claims processor | CLM-402197 → UHC-02849-78 (Susan Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010011 | Orphan claim re-pointed Claims processor | CLM-424264 → UHC-87981-39 (Frances Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010012 | Orphan claim re-pointed Claims processor | CLM-415722 → UHC-31896-42 (Benjamin Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010013 | Orphan claim re-pointed Claims processor | CLM-415307 → UHC-02916-39 (Christine Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010014 | Orphan claim re-pointed Claims processor | CLM-429506 → UHC-27382-79 (Douglas Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010015 | Orphan claim re-pointed Claims processor | CLM-414365 → UHC-96202-03 (Frank Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010016 | Orphan claim re-pointed Claims processor | CLM-401436 → UHC-18998-04 (Sharon Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010017 | Orphan claim re-pointed Claims processor | CLM-409323 → UHC-52450-28 (Jason Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010018 | Orphan claim re-pointed Claims processor | CLM-417674 → UHC-31390-71 (Donald Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010019 | Orphan claim re-pointed Claims processor | CLM-410683 → UHC-82828-61 (Teresa Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010020 | Orphan claim re-pointed Claims processor | CLM-406788 → UHC-98565-10 (Edward Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010021 | Orphan claim re-pointed Claims processor | CLM-426892 → UHC-05054-69 (Jason Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010022 | Orphan claim re-pointed Claims processor | CLM-422324 → UHC-48780-72 (Lawrence Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010023 | Orphan claim re-pointed Claims processor | CLM-410234 → UHC-64105-04 (Janice Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010024 | Orphan claim re-pointed Claims processor | CLM-408591 → UHC-34242-48 (George Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010025 | Orphan claim re-pointed Claims processor | CLM-429511 → UHC-72844-78 (Julia Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010026 | Orphan claim re-pointed Claims processor | CLM-426936 → UHC-69569-85 (Ashley Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010027 | Orphan claim re-pointed Claims processor | CLM-422277 → UHC-79227-30 (Henry Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010028 | Orphan claim re-pointed Claims processor | CLM-417927 → UHC-62395-04 (Sean Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010029 | Orphan claim re-pointed Claims processor | CLM-419074 → UHC-15887-53 (Jason Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010030 | Orphan claim re-pointed Claims processor | CLM-409327 → UHC-22617-58 (Anna Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010031 | Orphan claim re-pointed Claims processor | CLM-400912 → UHC-67411-72 (Joe Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010032 | Orphan claim re-pointed Claims processor | CLM-427169 → UHC-45325-26 (Bryan Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010033 | Orphan claim re-pointed Claims processor | CLM-405102 → UHC-54183-65 (Diane Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010034 | Orphan claim re-pointed Claims processor | CLM-408243 → UHC-24383-41 (Valentina Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010035 | Orphan claim re-pointed Claims processor | CLM-414828 → UHC-17569-05 (Henry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010036 | Orphan claim re-pointed Claims processor | CLM-410414 → UHC-20482-39 (Barbara Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010037 | Orphan claim re-pointed Claims processor | CLM-415618 → UHC-11101-95 (Logan Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010038 | Orphan claim re-pointed Claims processor | CLM-409670 → UHC-60955-53 (Jessica Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010039 | Orphan claim re-pointed Claims processor | CLM-405904 → UHC-66406-43 (Sophia Wagner) |
| 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.