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-002012 | Orphan claim re-pointed Claims processor | CLM-431309 → UHC-46316-68 (Keith Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002013 | Orphan claim re-pointed Claims processor | CLM-422139 → UHC-96670-88 (Danielle Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002014 | Orphan claim re-pointed Claims processor | CLM-418357 → UHC-72131-03 (Kelly Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002015 | Orphan claim re-pointed Claims processor | CLM-412299 → UHC-48583-08 (Lawrence Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002016 | Orphan claim re-pointed Claims processor | CLM-416348 → UHC-43813-38 (Arjun Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002017 | Orphan claim re-pointed Claims processor | CLM-403187 → UHC-21353-27 (Yuki Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002018 | Orphan claim re-pointed Claims processor | CLM-431050 → UHC-08508-41 (Lawrence Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002019 | Orphan claim re-pointed Claims processor | CLM-414216 → UHC-69077-72 (Anna Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002020 | Orphan claim re-pointed Claims processor | CLM-409441 → UHC-71182-79 (Cynthia Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002021 | Orphan claim re-pointed Claims processor | CLM-421886 → UHC-65472-14 (Brittany Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002022 | Orphan claim re-pointed Claims processor | CLM-406467 → UHC-85549-30 (Elizabeth Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002023 | Orphan claim re-pointed Claims processor | CLM-424446 → UHC-87508-67 (Angela Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002024 | Orphan claim re-pointed Claims processor | CLM-427195 → UHC-55154-36 (William Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002025 | Orphan claim re-pointed Claims processor | CLM-418936 → UHC-17261-98 (Eugene Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002026 | Orphan claim re-pointed Claims processor | CLM-403748 → UHC-93359-73 (Henry Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002027 | Orphan claim re-pointed Claims processor | CLM-407645 → UHC-42761-74 (Diana Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002028 | Orphan claim re-pointed Claims processor | CLM-425397 → UHC-27170-07 (Omar Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002029 | Orphan claim re-pointed Claims processor | CLM-421386 → UHC-60404-50 (Diae Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002030 | Orphan claim re-pointed Claims processor | CLM-415159 → UHC-82255-21 (Edward Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002031 | Orphan claim re-pointed Claims processor | CLM-424326 → UHC-24628-03 (Marcus Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002032 | Orphan claim re-pointed Claims processor | CLM-420388 → UHC-35643-74 (Mary Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002033 | Orphan claim re-pointed Claims processor | CLM-403299 → UHC-56034-99 (Daniel Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002034 | Orphan claim re-pointed Claims processor | CLM-420462 → UHC-71408-63 (Patrick Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002035 | Orphan claim re-pointed Claims processor | CLM-432347 → UHC-34112-33 (Jeremy Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002036 | Orphan claim re-pointed Claims processor | CLM-426334 → UHC-89853-24 (Alexis Crawfford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002037 | Orphan claim re-pointed Claims processor | CLM-426769 → UHC-35590-27 (Megan Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002038 | Orphan claim re-pointed Claims processor | CLM-421752 → UHC-84718-34 (Linda Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002039 | Orphan claim re-pointed Claims processor | CLM-423945 → UHC-49852-21 (Sandra Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002040 | Orphan claim re-pointed Claims processor | CLM-410703 → UHC-65972-52 (Sarah Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002041 | Orphan claim re-pointed Claims processor | CLM-417895 → UHC-55501-27 (Mark Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002042 | Orphan claim re-pointed Claims processor | CLM-400413 → UHC-45824-49 (John Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002043 | Orphan claim re-pointed Claims processor | CLM-422117 → UHC-78323-14 (Lucia Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002044 | Orphan claim re-pointed Claims processor | CLM-421019 → UHC-71391-15 (Alice Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002045 | Orphan claim re-pointed Claims processor | CLM-413780 → UHC-76213-90 (Gloria Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002046 | Orphan claim re-pointed Claims processor | CLM-410943 → UHC-34927-03 (Valentina Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002047 | Orphan claim re-pointed Claims processor | CLM-421720 → UHC-05079-55 (Mateo Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002048 | Orphan claim re-pointed Claims processor | CLM-402885 → UHC-65294-57 (Noah Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002049 | Orphan claim re-pointed Claims processor | CLM-408050 → UHC-09188-64 (Kathleen Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002050 | Orphan claim re-pointed Claims processor | CLM-430433 → UHC-51846-88 (Joan Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002051 | Orphan claim re-pointed Claims processor | CLM-416386 → UHC-74794-89 (Janice Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002052 | Orphan claim re-pointed Claims processor | CLM-407795 → UHC-52452-64 (Zachary Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002053 | Orphan claim re-pointed Claims processor | CLM-423552 → UHC-97296-45 (Doris Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002054 | Orphan claim re-pointed Claims processor | CLM-416197 → UHC-35967-43 (Justin Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002055 | Orphan claim re-pointed Claims processor | CLM-412022 → UHC-15571-41 (Patricia Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002056 | Orphan claim re-pointed Claims processor | CLM-401210 → UHC-70408-64 (Castro Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002057 | Orphan claim re-pointed Claims processor | CLM-404104 → UHC-74272-06 (Zachary Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002058 | Orphan claim re-pointed Claims processor | CLM-406432 → UHC-62397-46 (Billy Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002059 | Orphan claim re-pointed Claims processor | CLM-411430 → UHC-61111-61 (Joe Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002060 | Orphan claim re-pointed Claims processor | CLM-422863 → UHC-52538-51 (Alan Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002061 | Orphan claim re-pointed Claims processor | CLM-421417 → UHC-09033-92 (Yuki Contreras) |
| 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.