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-001862 | Orphan claim re-pointed Claims processor | CLM-420984 → UHC-75457-07 (Emily Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001863 | Orphan claim re-pointed Claims processor | CLM-423811 → UHC-01960-86 (Cynthia Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001864 | Orphan claim re-pointed Claims processor | CLM-423356 → UHC-55513-50 (Aaron Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001865 | Orphan claim re-pointed Claims processor | CLM-419738 → UHC-37330-92 (Kathryn Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001866 | Orphan claim re-pointed Claims processor | CLM-410185 → UHC-50173-29 (Sarah Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001867 | Orphan claim re-pointed Claims processor | CLM-429040 → UHC-34224-49 (Mei Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001868 | Orphan claim re-pointed Claims processor | CLM-403320 → UHC-16432-60 (Steven Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001869 | Orphan claim re-pointed Claims processor | CLM-416105 → UHC-44697-32 (Jon Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001870 | Orphan claim re-pointed Claims processor | CLM-421753 → UHC-84718-34 (Linda Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001871 | Orphan claim re-pointed Claims processor | CLM-432184 → UHC-41395-61 (Madison Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001872 | Orphan claim re-pointed Claims processor | CLM-404785 → UHC-44621-72 (Salazar Christian) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001873 | Orphan claim re-pointed Claims processor | CLM-425051 → UHC-92395-20 (Charles Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001874 | Orphan claim re-pointed Claims processor | CLM-432304 → UHC-41143-37 (Kayla Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001875 | Orphan claim re-pointed Claims processor | CLM-405084 → UHC-84948-25 (Judith Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001876 | Orphan claim re-pointed Claims processor | CLM-417320 → UHC-81179-53 (Alexis Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001877 | Orphan claim re-pointed Claims processor | CLM-401007 → UHC-31657-36 (Beverly Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001878 | Orphan claim re-pointed Claims processor | CLM-423818 → UHC-34539-08 (Yuki Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001879 | Orphan claim re-pointed Claims processor | CLM-430421 → UHC-45196-98 (Dennis Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001880 | Orphan claim re-pointed Claims processor | CLM-422168 → UHC-96032-88 (Virginia Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001881 | Orphan claim re-pointed Claims processor | CLM-407394 → UHC-82109-72 (Madison Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001882 | Orphan claim re-pointed Claims processor | CLM-413890 → UHC-46770-67 (Anthony Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001883 | Orphan claim re-pointed Claims processor | CLM-410231 → UHC-60881-82 (Paul Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001884 | Orphan claim re-pointed Claims processor | CLM-411429 → UHC-94285-65 (Jeremy Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001885 | Orphan claim re-pointed Claims processor | CLM-428000 → UHC-92037-28 (Daniel Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001886 | Orphan claim re-pointed Claims processor | CLM-407718 → UHC-21792-24 (Natalie Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001887 | Orphan claim re-pointed Claims processor | CLM-426630 → UHC-62320-38 (Barbara Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001888 | Orphan claim re-pointed Claims processor | CLM-405844 → UHC-70283-31 (Randy Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001889 | Orphan claim re-pointed Claims processor | CLM-411777 → UHC-43485-07 (Laura Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001890 | Orphan claim re-pointed Claims processor | CLM-415513 → UHC-73080-77 (Olivia Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001891 | Orphan claim re-pointed Claims processor | CLM-421338 → UHC-14676-12 (Stephanie Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001892 | Orphan claim re-pointed Claims processor | CLM-401387 → UHC-49702-48 (Katherine Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001893 | Orphan claim re-pointed Claims processor | CLM-429719 → UHC-53488-77 (Daniel Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001894 | Orphan claim re-pointed Claims processor | CLM-422233 → UHC-92658-26 (Patrick Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001895 | Orphan claim re-pointed Claims processor | CLM-422165 → UHC-88822-54 (Billy Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001896 | Orphan claim re-pointed Claims processor | CLM-417700 → UHC-89314-56 (Noah Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001897 | Orphan claim re-pointed Claims processor | CLM-430415 → UHC-71193-02 (Valentina Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001898 | Orphan claim re-pointed Claims processor | CLM-428741 → UHC-07918-81 (Henry Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001899 | Orphan claim re-pointed Claims processor | CLM-432554 → UHC-00116-94 (Sandra Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001900 | Orphan claim re-pointed Claims processor | CLM-406454 → UHC-02912-01 (Grace Mdeina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001901 | Orphan claim re-pointed Claims processor | CLM-400232 → UHC-55219-48 (Austin Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001902 | Orphan claim re-pointed Claims processor | CLM-401634 → UHC-05553-13 (Austin Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001903 | Orphan claim re-pointed Claims processor | CLM-418777 → UHC-29945-79 (Richard Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001904 | Orphan claim re-pointed Claims processor | CLM-417684 → UHC-62167-58 (Amy Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001905 | Orphan claim re-pointed Claims processor | CLM-417688 → UHC-47120-09 (Patricia Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001906 | Orphan claim re-pointed Claims processor | CLM-422957 → UHC-76265-13 (Kathleen Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001907 | Orphan claim re-pointed Claims processor | CLM-424175 → UHC-90955-10 (Doris Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001908 | Orphan claim re-pointed Claims processor | CLM-407859 → UHC-88715-46 (Ronald Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001909 | Orphan claim re-pointed Claims processor | CLM-427629 → UHC-52328-19 (Jordan Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001910 | Orphan claim re-pointed Claims processor | CLM-403878 → UHC-38340-41 (Andrea Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001911 | Orphan claim re-pointed Claims processor | CLM-402340 → UHC-46654-44 (Aisha Simmons) |
| 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.