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-010040 | Orphan claim re-pointed Claims processor | CLM-427113 → UHC-26033-66 (Jeremy Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010041 | Orphan claim re-pointed Claims processor | CLM-403874 → UHC-02224-53 (Hiroshi Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010042 | Orphan claim re-pointed Claims processor | CLM-419465 → UHC-82541-14 (Steven Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010043 | Orphan claim re-pointed Claims processor | CLM-414190 → UHC-02844-10 (Lori Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010044 | Orphan claim re-pointed Claims processor | CLM-413342 → UHC-87948-44 (Samantha Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010045 | Orphan claim re-pointed Claims processor | CLM-423909 → UHC-22890-68 (Ryan Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010046 | Orphan claim re-pointed Claims processor | CLM-407907 → UHC-74103-47 (Heather Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010047 | Orphan claim re-pointed Claims processor | CLM-421458 → UHC-10409-87 (Samantha Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010048 | Orphan claim re-pointed Claims processor | CLM-423277 → UHC-75430-55 (Maria Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010049 | Orphan claim re-pointed Claims processor | CLM-422673 → UHC-05228-53 (Cheryl Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010050 | Orphan claim re-pointed Claims processor | CLM-430013 → UHC-80079-74 (Diane Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010051 | Orphan claim re-pointed Claims processor | CLM-412885 → UHC-35985-56 (Joyce Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010052 | Orphan claim re-pointed Claims processor | CLM-416893 → UHC-72598-96 (Jordan Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010053 | Orphan claim re-pointed Claims processor | CLM-415928 → UHC-48449-29 (Ronald Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010054 | Orphan claim re-pointed Claims processor | CLM-401726 → UHC-14814-27 (Emma Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010055 | Orphan claim re-pointed Claims processor | CLM-407297 → UHC-77404-59 (Ann Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010056 | Orphan claim re-pointed Claims processor | CLM-414567 → UHC-66030-92 (Lisa Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010057 | Orphan claim re-pointed Claims processor | CLM-429664 → UHC-61087-91 (Shirley Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010058 | Orphan claim re-pointed Claims processor | CLM-430667 → UHC-46221-83 (Doriis Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010059 | Orphan claim re-pointed Claims processor | CLM-407143 → UHC-44967-83 (Dylan Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010060 | Orphan claim re-pointed Claims processor | CLM-421437 → UHC-05630-68 (Carol Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010061 | Orphan claim re-pointed Claims processor | CLM-413370 → UHC-00927-15 (Marcus White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010062 | Orphan claim re-pointed Claims processor | CLM-430744 → UHC-63312-69 (Larry Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010063 | Orphan claim re-pointed Claims processor | CLM-424905 → UHC-96295-40 (Mei Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010064 | Orphan claim re-pointed Claims processor | CLM-406392 → UHC-55401-63 (Margaret Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010065 | Orphan claim re-pointed Claims processor | CLM-402078 → UHC-66269-80 (Carlos Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010066 | Orphan claim re-pointed Claims processor | CLM-400724 → UHC-78696-43 (Patrick Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010067 | Orphan claim re-pointed Claims processor | CLM-425693 → UHC-86595-66 (Mei Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010068 | Orphan claim re-pointed Claims processor | CLM-422436 → UHC-38077-37 (Kayla Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010069 | Orphan claim re-pointed Claims processor | CLM-409020 → UHC-42573-98 (Mei Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010070 | Orphan claim re-pointed Claims processor | CLM-425865 → UHC-28110-84 (Roger Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010071 | Orphan claim re-pointed Claims processor | CLM-404866 → UHC-54218-68 (Elyzabeth Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010072 | Orphan claim re-pointed Claims processor | CLM-412548 → UHC-34040-77 (Rachel Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010073 | Orphan claim re-pointed Claims processor | CLM-413226 → UHC-38218-33 (Joan Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010074 | Orphan claim re-pointed Claims processor | CLM-418184 → UHC-08711-40 (Sean Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010075 | Orphan claim re-pointed Claims processor | CLM-417631 → UHC-31744-18 (Walter Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010076 | Orphan claim re-pointed Claims processor | CLM-412364 → UHC-14586-75 (Kevin Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010077 | Orphan claim re-pointed Claims processor | CLM-415744 → UHC-82208-74 (Nancy Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010078 | Orphan claim re-pointed Claims processor | CLM-401646 → UHC-81160-47 (Mike Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010079 | Orphan claim re-pointed Claims processor | CLM-400579 → UHC-73966-23 (Jacob Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010080 | Orphan claim re-pointed Claims processor | CLM-403597 → UHC-44529-74 (Isabella Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010081 | Orphan claim re-pointed Claims processor | CLM-430418 → UHC-93555-02 (Denise Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010082 | Orphan claim re-pointed Claims processor | CLM-431908 → UHC-23354-60 (Zachary Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010083 | Orphan claim re-pointed Claims processor | CLM-415240 → UHC-84488-96 (Aisha Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010084 | Orphan claim re-pointed Claims processor | CLM-428244 → UHC-44389-59 (Jacqueline West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010085 | Orphan claim re-pointed Claims processor | CLM-412276 → UHC-22875-45 (Catherine Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010086 | Orphan claim re-pointed Claims processor | CLM-425359 → UHC-45106-07 (Nathan Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010087 | Orphan claim re-pointed Claims processor | CLM-431286 → UHC-71520-80 (Nicholas Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010088 | Orphan claim re-pointed Claims processor | CLM-420480 → UHC-33697-52 (Martha Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010089 | Orphan claim re-pointed Claims processor | CLM-414460 → UHC-99638-91 (Noah Garrett) |
| 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.