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-010190 | Orphan claim re-pointed Claims processor | CLM-400756 → UHC-13708-40 (Michelle Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010191 | Orphan claim re-pointed Claims processor | CLM-424438 → UHC-41300-78 (Andrea Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010192 | Orphan claim re-pointed Claims processor | CLM-414623 → UHC-40907-37 (Arthur Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010193 | Orphan claim re-pointed Claims processor | CLM-430599 → UHC-08712-31 (Willie Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010194 | Orphan claim re-pointed Claims processor | CLM-412825 → UHC-53198-74 (George Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010195 | Orphan claim re-pointed Claims processor | CLM-412407 → UHC-64907-39 (Olivia Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010196 | Orphan claim re-pointed Claims processor | CLM-418482 → UHC-73122-43 (Denise Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010197 | Orphan claim re-pointed Claims processor | CLM-410262 → UHC-43299-12 (Debra Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010198 | Orphan claim re-pointed Claims processor | CLM-420785 → UHC-23024-76 (Jordan Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010199 | Orphan claim re-pointed Claims processor | CLM-418047 → UHC-70128-75 (Joseph Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010200 | Orphan claim re-pointed Claims processor | CLM-406179 → UHC-65610-09 (Ronald Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010201 | Orphan claim re-pointed Claims processor | CLM-423522 → UHC-72782-15 (Yuki Sandes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010202 | Orphan claim re-pointed Claims processor | CLM-428583 → UHC-92566-61 (Melissa Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010203 | Orphan claim re-pointed Claims processor | CLM-428513 → UHC-54516-18 (Hannah Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010204 | Orphan claim re-pointed Claims processor | CLM-413824 → UHC-62649-74 (Nathan Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010205 | Orphan claim re-pointed Claims processor | CLM-410139 → UHC-53744-28 (Samuel Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010206 | Orphan claim re-pointed Claims processor | CLM-405417 → UHC-21603-47 (Roger Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010207 | Orphan claim re-pointed Claims processor | CLM-400607 → UHC-89525-68 (Marcus Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010208 | Orphan claim re-pointed Claims processor | CLM-417870 → UHC-14155-80 (Heather Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010209 | Orphan claim re-pointed Claims processor | CLM-413130 → UHC-44827-08 (Sarah Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010210 | Orphan claim re-pointed Claims processor | CLM-410023 → UHC-34633-94 (Tyler Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010211 | Orphan claim re-pointed Claims processor | CLM-421778 → UHC-68512-24 (Rachel Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010212 | Orphan claim re-pointed Claims processor | CLM-417239 → UHC-91325-54 (Susan Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010213 | Orphan claim re-pointed Claims processor | CLM-406005 → UHC-08282-28 (Janice Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010214 | Orphan claim re-pointed Claims processor | CLM-420758 → UHC-64993-34 (Mark Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010215 | Orphan claim re-pointed Claims processor | CLM-400626 → UHC-05475-09 (Jesse Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010216 | Orphan claim re-pointed Claims processor | CLM-418688 → UHC-38561-21 (Elijah Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010217 | Orphan claim re-pointed Claims processor | CLM-419574 → UHC-25806-40 (Dylan Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010218 | Orphan claim re-pointed Claims processor | CLM-415039 → UHC-50091-64 (Danielle Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010219 | Orphan claim re-pointed Claims processor | CLM-410876 → UHC-09860-18 (Hiroshi Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010220 | Orphan claim re-pointed Claims processor | CLM-407652 → UHC-03929-94 (Jacob Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010221 | Orphan claim re-pointed Claims processor | CLM-428730 → UHC-81180-90 (Joan Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010222 | Orphan claim re-pointed Claims processor | CLM-405101 → UHC-54183-65 (Diane Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010223 | Orphan claim re-pointed Claims processor | CLM-403831 → UHC-79504-51 (Lori Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010224 | Orphan claim re-pointed Claims processor | CLM-403149 → UHC-31832-19 (Melissa Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010225 | Orphan claim re-pointed Claims processor | CLM-419723 → UHC-42367-40 (Mason Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010226 | Orphan claim re-pointed Claims processor | CLM-415774 → UHC-69492-79 (Carlos Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010227 | Orphan claim re-pointed Claims processor | CLM-406528 → UHC-57674-38 (Lauren Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010228 | Orphan claim re-pointed Claims processor | CLM-407750 → UHC-37873-89 (Katherine Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010229 | Orphan claim re-pointed Claims processor | CLM-419503 → UHC-76276-79 (Andrew Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010230 | Orphan claim re-pointed Claims processor | CLM-428026 → UHC-44867-77 (Deborah Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010231 | Orphan claim re-pointed Claims processor | CLM-407902 → UHC-47589-10 (Bradley Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010232 | Orphan claim re-pointed Claims processor | CLM-402339 → UHC-46654-44 (Aisha Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010233 | Orphan claim re-pointed Claims processor | CLM-411954 → UHC-24377-82 (Ruth Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010234 | Orphan claim re-pointed Claims processor | CLM-406680 → UHC-98198-45 (Dorothy Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010235 | Orphan claim re-pointed Claims processor | CLM-424910 → UHC-60029-27 (Russell Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010236 | Orphan claim re-pointed Claims processor | CLM-414614 → UHC-66499-96 (Beverly Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010237 | Orphan claim re-pointed Claims processor | CLM-401053 → UHC-19364-47 (Rebecca Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010238 | Orphan claim re-pointed Claims processor | CLM-402897 → UHC-27015-08 (Wayne Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010239 | Orphan claim re-pointed Claims processor | CLM-402867 → UHC-97453-82 (Ann Alexandre) |
| 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.