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-001812 | Orphan claim re-pointed Claims processor | CLM-411493 → UHC-44996-73 (Gerald Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001813 | Orphan claim re-pointed Claims processor | CLM-412813 → UHC-66814-69 (Camila Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001814 | Orphan claim re-pointed Claims processor | CLM-406027 → UHC-17618-84 (Douglas Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001815 | Orphan claim re-pointed Claims processor | CLM-428304 → UHC-96551-62 (Janice Sto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001816 | Orphan claim re-pointed Claims processor | CLM-417139 → UHC-27455-47 (Daniel Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001817 | Orphan claim re-pointed Claims processor | CLM-404352 → UHC-42414-79 (Pamela Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001818 | Orphan claim re-pointed Claims processor | CLM-412244 → UHC-40023-82 (Victoria Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001819 | Orphan claim re-pointed Claims processor | CLM-406055 → UHC-83119-24 (Hannah Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001820 | Orphan claim re-pointed Claims processor | CLM-406954 → UHC-12897-50 (Kevin Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001821 | Orphan claim re-pointed Claims processor | CLM-419205 → UHC-74235-33 (Charlotte Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001822 | Orphan claim re-pointed Claims processor | CLM-408396 → UHC-43018-83 (Jacqueline Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001823 | Orphan claim re-pointed Claims processor | CLM-419943 → UHC-60747-77 (Robert Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001824 | Orphan claim re-pointed Claims processor | CLM-401442 → UHC-13842-70 (Daniel Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001825 | Orphan claim re-pointed Claims processor | CLM-400048 → UHC-03918-71 (Doris Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001826 | Orphan claim re-pointed Claims processor | CLM-429879 → UHC-64751-19 (Julie Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001827 | Orphan claim re-pointed Claims processor | CLM-420590 → UHC-54455-12 (Emma Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001828 | Orphan claim re-pointed Claims processor | CLM-430896 → UHC-92970-85 (Valentina Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001829 | Orphan claim re-pointed Claims processor | CLM-428988 → UHC-73011-94 (Walter Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001830 | Orphan claim re-pointed Claims processor | CLM-412649 → UHC-69097-81 (Janet Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001831 | Orphan claim re-pointed Claims processor | CLM-419510 → UHC-81159-03 (Angela Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001832 | Orphan claim re-pointed Claims processor | CLM-412398 → UHC-73546-71 (Scott Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001833 | Orphan claim re-pointed Claims processor | CLM-425581 → UHC-07621-24 (Douglas Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001834 | Orphan claim re-pointed Claims processor | CLM-409817 → UHC-52639-41 (Hiroshi Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001835 | Orphan claim re-pointed Claims processor | CLM-403920 → UHC-05862-91 (Zachary Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001836 | Orphan claim re-pointed Claims processor | CLM-411231 → UHC-89373-58 (Camila Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001837 | Orphan claim re-pointed Claims processor | CLM-411494 → UHC-29390-48 (Kayla Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001838 | Orphan claim re-pointed Claims processor | CLM-415319 → UHC-55250-97 (Andrea Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001839 | Orphan claim re-pointed Claims processor | CLM-409450 → UHC-21212-52 (Rachel Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001840 | Orphan claim re-pointed Claims processor | CLM-407123 → UHC-54614-81 (Gerald Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001841 | Orphan claim re-pointed Claims processor | CLM-410217 → UHC-06564-81 (David Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001842 | Orphan claim re-pointed Claims processor | CLM-416307 → UHC-14526-69 (Virginia Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001843 | Orphan claim re-pointed Claims processor | CLM-420069 → UHC-13976-98 (Emma Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001844 | Orphan claim re-pointed Claims processor | CLM-428714 → UHC-81755-94 (Omar Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001845 | Orphan claim re-pointed Claims processor | CLM-417167 → UHC-31996-82 (Matthew Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001846 | Orphan claim re-pointed Claims processor | CLM-412682 → UHC-56887-73 (Luis Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001847 | Orphan claim re-pointed Claims processor | CLM-428705 → UHC-76593-95 (Kathryn Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001848 | Orphan claim re-pointed Claims processor | CLM-413479 → UHC-29432-01 (Carol Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001849 | Orphan claim re-pointed Claims processor | CLM-430086 → UHC-35018-52 (Amy Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001850 | Orphan claim re-pointed Claims processor | CLM-410909 → UHC-70476-15 (Carol Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001851 | Orphan claim re-pointed Claims processor | CLM-406832 → UHC-83948-75 (Philip Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001852 | Orphan claim re-pointed Claims processor | CLM-422209 → UHC-89453-55 (Vincent Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001853 | Orphan claim re-pointed Claims processor | CLM-432164 → UHC-72535-35 (Rachel Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001854 | Orphan claim re-pointed Claims processor | CLM-410999 → UHC-77031-08 (Jimmy Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001855 | Orphan claim re-pointed Claims processor | CLM-402758 → UHC-45402-41 (James Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001856 | Orphan claim re-pointed Claims processor | CLM-432560 → UHC-35446-77 (Amanda Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001857 | Orphan claim re-pointed Claims processor | CLM-432419 → UHC-25443-03 (Barbara Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001858 | Orphan claim re-pointed Claims processor | CLM-417706 → UHC-77127-65 (Betty Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001859 | Orphan claim re-pointed Claims processor | CLM-418167 → UHC-71686-49 (Ana Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001860 | Orphan claim re-pointed Claims processor | CLM-429823 → UHC-09008-65 (Hannah Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001861 | Orphan claim re-pointed Claims processor | CLM-401161 → UHC-58991-88 (Bryan Hansen) |
| 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.