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-001962 | Orphan claim re-pointed Claims processor | CLM-404475 → UHC-81889-78 (Billy Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001963 | Orphan claim re-pointed Claims processor | CLM-419618 → UHC-34568-51 (Aaron Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001964 | Orphan claim re-pointed Claims processor | CLM-406616 → UHC-14987-56 (Denise Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001965 | Orphan claim re-pointed Claims processor | CLM-407999 → UHC-72810-50 (Jean Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001966 | Orphan claim re-pointed Claims processor | CLM-405300 → UHC-47191-35 (Austin Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001967 | Orphan claim re-pointed Claims processor | CLM-424148 → UHC-12380-01 (Angela Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001968 | Orphan claim re-pointed Claims processor | CLM-410133 → UHC-11547-97 (Andrew Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001969 | Orphan claim re-pointed Claims processor | CLM-417074 → UHC-24476-29 (Hannah Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001970 | Orphan claim re-pointed Claims processor | CLM-426682 → UHC-46251-99 (Judith Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001971 | Orphan claim re-pointed Claims processor | CLM-415321 → UHC-06505-43 (Wayne Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001972 | Orphan claim re-pointed Claims processor | CLM-410299 → UHC-33350-17 (Bruce Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001973 | Orphan claim re-pointed Claims processor | CLM-412516 → UHC-63950-13 (Edward Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001974 | Orphan claim re-pointed Claims processor | CLM-415250 → UHC-20079-30 (Tyler Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001975 | Orphan claim re-pointed Claims processor | CLM-429859 → UHC-19864-11 (Noah Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001976 | Orphan claim re-pointed Claims processor | CLM-406518 → UHC-44206-31 (Sarah Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001977 | Orphan claim re-pointed Claims processor | CLM-422405 → UHC-80915-35 (Mei Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001978 | Orphan claim re-pointed Claims processor | CLM-410608 → UHC-60515-86 (Mei Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001979 | Orphan claim re-pointed Claims processor | CLM-423976 → UHC-94658-36 (Luis Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001980 | Orphan claim re-pointed Claims processor | CLM-421222 → UHC-45946-22 (Christian Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001981 | Orphan claim re-pointed Claims processor | CLM-431123 → UHC-06582-86 (Jacob Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001982 | Orphan claim re-pointed Claims processor | CLM-431749 → UHC-00957-09 (Mari Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001983 | Orphan claim re-pointed Claims processor | CLM-428193 → UHC-40906-06 (Noah Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001984 | Orphan claim re-pointed Claims processor | CLM-423692 → UHC-53868-27 (Deborah Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001985 | Orphan claim re-pointed Claims processor | CLM-420938 → UHC-74540-84 (Judith Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001986 | Orphan claim re-pointed Claims processor | CLM-432326 → UHC-53497-10 (Walter Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001987 | Orphan claim re-pointed Claims processor | CLM-408454 → UHC-03826-60 (Margaret Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001988 | Orphan claim re-pointed Claims processor | CLM-405593 → UHC-23703-76 (Catherine Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001989 | Orphan claim re-pointed Claims processor | CLM-421711 → UHC-84006-39 (Laura Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001990 | Orphan claim re-pointed Claims processor | CLM-411709 → UHC-16569-19 (Anthony Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001991 | Orphan claim re-pointed Claims processor | CLM-417644 → UHC-96404-93 (Diana Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001992 | Orphan claim re-pointed Claims processor | CLM-417477 → UHC-63138-71 (Jose Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001993 | Orphan claim re-pointed Claims processor | CLM-421224 → UHC-96485-89 (Logan Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001994 | Orphan claim re-pointed Claims processor | CLM-407594 → UHC-41260-98 (Betty Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001995 | Orphan claim re-pointed Claims processor | CLM-413056 → UHC-60527-88 (Judy Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001996 | Orphan claim re-pointed Claims processor | CLM-412759 → UHC-55265-39 (Jerry Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001997 | Orphan claim re-pointed Claims processor | CLM-411998 → UHC-66353-78 (Lisa Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001998 | Orphan claim re-pointed Claims processor | CLM-402639 → UHC-32697-71 (Gregory Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-001999 | Orphan claim re-pointed Claims processor | CLM-405644 → UHC-44797-11 (Stephen Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002000 | Orphan claim re-pointed Claims processor | CLM-415042 → UHC-06443-59 (Yuki Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002001 | Orphan claim re-pointed Claims processor | CLM-410700 → UHC-84467-90 (Brandon Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002002 | Orphan claim re-pointed Claims processor | CLM-426689 → UHC-04955-08 (Eric Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002003 | Orphan claim re-pointed Claims processor | CLM-422470 → UHC-15077-93 (Russell Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002004 | Orphan claim re-pointed Claims processor | CLM-415565 → UHC-26376-31 (Fatima Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002005 | Orphan claim re-pointed Claims processor | CLM-419608 → UHC-09077-92 (Isabella Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002006 | Orphan claim re-pointed Claims processor | CLM-425828 → UHC-24006-94 (Katherine Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002007 | Orphan claim re-pointed Claims processor | CLM-404056 → UHC-63165-77 (Lawrence Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002008 | Orphan claim re-pointed Claims processor | CLM-429469 → UHC-32314-83 (Martha West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002009 | Orphan claim re-pointed Claims processor | CLM-404339 → UHC-95183-75 (Madison Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002010 | Orphan claim re-pointed Claims processor | CLM-402449 → UHC-10340-59 (Elizabeth Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002011 | Orphan claim re-pointed Claims processor | CLM-424543 → UHC-62518-63 (Judy Walker) |
| 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.