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-002190 | Orphan claim re-pointed Claims processor | CLM-428379 → UHC-91491-21 (Cheryl Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002191 | Orphan claim re-pointed Claims processor | CLM-403204 → UHC-57189-74 (Mariana Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002192 | Orphan claim re-pointed Claims processor | CLM-413907 → UHC-39197-67 (Kathryn Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002193 | Orphan claim re-pointed Claims processor | CLM-408926 → UHC-20749-55 (Eugene Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002194 | Orphan claim re-pointed Claims processor | CLM-414790 → UHC-63709-36 (Brenda Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002195 | Orphan claim re-pointed Claims processor | CLM-423874 → UHC-26130-42 (Jennifer Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002196 | Orphan claim re-pointed Claims processor | CLM-412982 → UHC-09672-15 (Katherine Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002197 | Orphan claim re-pointed Claims processor | CLM-416713 → UHC-90396-64 (Elijah Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002198 | Orphan claim re-pointed Claims processor | CLM-422232 → UHC-49624-39 (Hiroshi Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002199 | Orphan claim re-pointed Claims processor | CLM-403481 → UHC-74279-34 (Hiroshi Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002200 | Orphan claim re-pointed Claims processor | CLM-408695 → UHC-59734-47 (Aisha Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002201 | Orphan claim re-pointed Claims processor | CLM-409040 → UHC-95612-32 (Catherine Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002202 | Orphan claim re-pointed Claims processor | CLM-406370 → UHC-10686-47 (Carlos Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002203 | Orphan claim re-pointed Claims processor | CLM-425824 → UHC-48248-88 (Kathryn Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002204 | Orphan claim re-pointed Claims processor | CLM-414526 → UHC-97361-74 (Mariana Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002205 | Orphan claim re-pointed Claims processor | CLM-426743 → UHC-40588-93 (Brenda Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002206 | Orphan claim re-pointed Claims processor | CLM-412109 → UHC-13171-62 (Marilyn Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002207 | Orphan claim re-pointed Claims processor | CLM-421759 → UHC-97057-97 (Isabella Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002208 | Orphan claim re-pointed Claims processor | CLM-414605 → UHC-87902-53 (Marilyn Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002209 | Orphan claim re-pointed Claims processor | CLM-402780 → UHC-93026-58 (Carol Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002210 | Orphan claim re-pointed Claims processor | CLM-400608 → UHC-30577-22 (Kenneth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002211 | Orphan claim re-pointed Claims processor | CLM-408472 → UHC-39628-85 (Thomas Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002212 | Orphan claim re-pointed Claims processor | CLM-419596 → UHC-89972-01 (Emma Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002213 | Orphan claim re-pointed Claims processor | CLM-412617 → UHC-16469-95 (Diego Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002214 | Orphan claim re-pointed Claims processor | CLM-419229 → UHC-96719-08 (Vincent Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002215 | Orphan claim re-pointed Claims processor | CLM-418290 → UHC-80393-56 (Laura Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002216 | Orphan claim re-pointed Claims processor | CLM-403493 → UHC-33124-31 (Maria Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002217 | Orphan claim re-pointed Claims processor | CLM-411048 → UHC-69531-75 (Lauren Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002218 | Orphan claim re-pointed Claims processor | CLM-409836 → UHC-45718-66 (Russell Wagnner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002219 | Orphan claim re-pointed Claims processor | CLM-411765 → UHC-94739-65 (Jeffrey Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002220 | Orphan claim re-pointed Claims processor | CLM-407506 → UHC-39813-91 (Daniel Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002221 | Orphan claim re-pointed Claims processor | CLM-429289 → UHC-96611-25 (Virginia Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002222 | Orphan claim re-pointed Claims processor | CLM-405734 → UHC-84048-28 (Beverly Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002223 | Orphan claim re-pointed Claims processor | CLM-410130 → UHC-97234-36 (Stephanie Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002224 | Orphan claim re-pointed Claims processor | CLM-415599 → UHC-77555-18 (Anna Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002225 | Orphan claim re-pointed Claims processor | CLM-409897 → UHC-68954-36 (William Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002226 | Orphan claim re-pointed Claims processor | CLM-409614 → UHC-10777-03 (Mason Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002227 | Orphan claim re-pointed Claims processor | CLM-424729 → UHC-00426-62 (Philip Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002228 | Orphan claim re-pointed Claims processor | CLM-416643 → UHC-50641-01 (Susan Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002229 | Orphan claim re-pointed Claims processor | CLM-403436 → UHC-26841-91 (Carol Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002230 | Orphan claim re-pointed Claims processor | CLM-402744 → UHC-82396-81 (Daine Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002231 | Orphan claim re-pointed Claims processor | CLM-404233 → UHC-70145-78 (Pamela Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002232 | Orphan claim re-pointed Claims processor | CLM-417374 → UHC-01959-63 (Sean Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002233 | Orphan claim re-pointed Claims processor | CLM-418825 → UHC-22068-37 (Carlos Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002234 | Orphan claim re-pointed Claims processor | CLM-417449 → UHC-44662-69 (Kathy Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002235 | Orphan claim re-pointed Claims processor | CLM-412319 → UHC-16932-07 (Alice Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002236 | Orphan claim re-pointed Claims processor | CLM-408386 → UHC-38598-92 (Elizabeth Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002237 | Orphan claim re-pointed Claims processor | CLM-408232 → UHC-83378-94 (Olivia Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002238 | Orphan claim re-pointed Claims processor | CLM-407033 → UHC-15519-28 (Joyce Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002239 | Orphan claim re-pointed Claims processor | CLM-421792 → UHC-21801-43 (Isabella Santos) |
| 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.