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-001912 | Orphan claim re-pointed Claims processor | CLM-428387 → UHC-28056-92 (Harold Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001913 | Orphan claim re-pointed Claims processor | CLM-409886 → UHC-22343-80 (Bobby Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001914 | Orphan claim re-pointed Claims processor | CLM-407098 → UHC-37501-46 (Gerald Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001915 | Orphan claim re-pointed Claims processor | CLM-410671 → UHC-95603-42 (Michael Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001916 | Orphan claim re-pointed Claims processor | CLM-402125 → UHC-51969-60 (Isabella Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001917 | Orphan claim re-pointed Claims processor | CLM-432660 → UHC-62359-22 (Brian Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001918 | Orphan claim re-pointed Claims processor | CLM-422924 → UHC-25565-57 (Ahmed Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001919 | Orphan claim re-pointed Claims processor | CLM-427643 → UHC-20327-47 (Gary Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001920 | Orphan claim re-pointed Claims processor | CLM-403237 → UHC-69234-20 (Richard Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001921 | Orphan claim re-pointed Claims processor | CLM-421344 → UHC-96379-79 (Camila Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001922 | Orphan claim re-pointed Claims processor | CLM-401273 → UHC-76399-31 (Mason Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001923 | Orphan claim re-pointed Claims processor | CLM-419874 → UHC-65268-22 (Jessiac Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001924 | Orphan claim re-pointed Claims processor | CLM-401329 → UHC-13328-28 (Amy Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001925 | Orphan claim re-pointed Claims processor | CLM-409582 → UHC-53110-32 (Jennifer Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001926 | Orphan claim re-pointed Claims processor | CLM-424345 → UHC-60010-83 (Heather Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001927 | Orphan claim re-pointed Claims processor | CLM-420710 → UHC-90571-84 (Kathleen Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001928 | Orphan claim re-pointed Claims processor | CLM-417420 → UHC-72089-26 (Juan Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001929 | Orphan claim re-pointed Claims processor | CLM-425896 → UHC-84096-55 (Susan Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001930 | Orphan claim re-pointed Claims processor | CLM-408089 → UHC-90777-05 (Kathryn Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001931 | Orphan claim re-pointed Claims processor | CLM-401765 → UHC-97777-83 (Walter Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001932 | Orphan claim re-pointed Claims processor | CLM-420604 → UHC-81240-57 (Billy Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001933 | Orphan claim re-pointed Claims processor | CLM-404703 → UHC-03406-45 (Joseph Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001934 | Orphan claim re-pointed Claims processor | CLM-423577 → UHC-11079-43 (Peter Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001935 | Orphan claim re-pointed Claims processor | CLM-427855 → UHC-45242-14 (Sara Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001936 | Orphan claim re-pointed Claims processor | CLM-426194 → UHC-65976-64 (Judy Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001937 | Orphan claim re-pointed Claims processor | CLM-425142 → UHC-18562-31 (Gerald Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001938 | Orphan claim re-pointed Claims processor | CLM-416640 → UHC-43941-81 (Ralph Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001939 | Orphan claim re-pointed Claims processor | CLM-428903 → UHC-01255-44 (William Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001940 | Orphan claim re-pointed Claims processor | CLM-403316 → UHC-33275-94 (Scott Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001941 | Orphan claim re-pointed Claims processor | CLM-424825 → UHC-99586-03 (Dennis Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001942 | Orphan claim re-pointed Claims processor | CLM-406473 → UHC-44301-74 (Laura Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001943 | Orphan claim re-pointed Claims processor | CLM-421727 → UHC-88787-58 (Mason Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001944 | Orphan claim re-pointed Claims processor | CLM-412984 → UHC-09672-15 (Katherine Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001945 | Orphan claim re-pointed Claims processor | CLM-427208 → UHC-79652-17 (Julei Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001946 | Orphan claim re-pointed Claims processor | CLM-427555 → UHC-47559-10 (Kimberly Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001947 | Orphan claim re-pointed Claims processor | CLM-414755 → UHC-87599-06 (Sandra Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001948 | Orphan claim re-pointed Claims processor | CLM-406282 → UHC-30938-27 (Eric Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001949 | Orphan claim re-pointed Claims processor | CLM-411096 → UHC-39290-82 (Brittany Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001950 | Orphan claim re-pointed Claims processor | CLM-409163 → UHC-16666-12 (Nicole Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001951 | Orphan claim re-pointed Claims processor | CLM-410705 → UHC-58876-62 (Jacob Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001952 | Orphan claim re-pointed Claims processor | CLM-428457 → UHC-75478-15 (Judith Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001953 | Orphan claim re-pointed Claims processor | CLM-420147 → UHC-21009-42 (Susan Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001954 | Orphan claim re-pointed Claims processor | CLM-432402 → UHC-35606-34 (Peter Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001955 | Orphan claim re-pointed Claims processor | CLM-418870 → UHC-43519-95 (Kathryn Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001956 | Orphan claim re-pointed Claims processor | CLM-430446 → UHC-97803-20 (Mariana Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001957 | Orphan claim re-pointed Claims processor | CLM-408775 → UHC-29986-91 (Gary Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001958 | Orphan claim re-pointed Claims processor | CLM-427701 → UHC-33223-95 (Katherine West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001959 | Orphan claim re-pointed Claims processor | CLM-428353 → UHC-58395-71 (Keith Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001960 | Orphan claim re-pointed Claims processor | CLM-432168 → UHC-83355-82 (Logan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001961 | Orphan claim re-pointed Claims processor | CLM-400855 → UHC-59014-76 (Carol Porter) |
| 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.