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-002062 | Orphan claim re-pointed Claims processor | CLM-401367 → UHC-86812-10 (Angela Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002063 | Orphan claim re-pointed Claims processor | CLM-421211 → UHC-78273-41 (Steven Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002064 | Orphan claim re-pointed Claims processor | CLM-422270 → UHC-90765-54 (James Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002065 | Orphan claim re-pointed Claims processor | CLM-421305 → UHC-17475-99 (Judy Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002066 | Orphan claim re-pointed Claims processor | CLM-424470 → UHC-19581-78 (Richard Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002067 | Orphan claim re-pointed Claims processor | CLM-432250 → UHC-95527-11 (Catherine Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002068 | Orphan claim re-pointed Claims processor | CLM-420027 → UHC-74272-20 (Austin Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002069 | Orphan claim re-pointed Claims processor | CLM-406229 → UHC-31788-54 (William Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002070 | Orphan claim re-pointed Claims processor | CLM-431266 → UHC-89349-54 (Priya Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002071 | Orphan claim re-pointed Claims processor | CLM-411175 → UHC-47951-04 (Betty Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002072 | Orphan claim re-pointed Claims processor | CLM-411766 → UHC-94739-65 (Jeffrey Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002073 | Orphan claim re-pointed Claims processor | CLM-419800 → UHC-19446-14 (Diane Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002074 | Orphan claim re-pointed Claims processor | CLM-414838 → UHC-66059-99 (Lawrence Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002075 | Orphan claim re-pointed Claims processor | CLM-427951 → UHC-00785-53 (Elijah Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002076 | Orphan claim re-pointed Claims processor | CLM-406781 → UHC-69527-63 (Billy Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002077 | Orphan claim re-pointed Claims processor | CLM-403677 → UHC-97161-69 (Raymond Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002078 | Orphan claim re-pointed Claims processor | CLM-414347 → UHC-25569-64 (Henry Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002079 | Orphan claim re-pointed Claims processor | CLM-403203 → UHC-86954-11 (Anthony Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002080 | Orphan claim re-pointed Claims processor | CLM-402622 → UHC-18828-56 (Luis Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002081 | Orphan claim re-pointed Claims processor | CLM-423623 → UHC-64772-95 (Ana Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002082 | Orphan claim re-pointed Claims processor | CLM-420637 → UHC-46022-88 (Grace Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002083 | Orphan claim re-pointed Claims processor | CLM-402157 → UHC-42957-58 (Luis Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002084 | Orphan claim re-pointed Claims processor | CLM-420696 → UHC-70738-77 (Sarah Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002085 | Orphan claim re-pointed Claims processor | CLM-422189 → UHC-17881-72 (Raymond Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002086 | Orphan claim re-pointed Claims processor | CLM-430813 → UHC-14709-75 (Andrea Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002087 | Orphan claim re-pointed Claims processor | CLM-416021 → UHC-51511-77 (Mark Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002088 | Orphan claim re-pointed Claims processor | CLM-420595 → UHC-65148-82 (Evelyn Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002089 | Orphan claim re-pointed Claims processor | CLM-410432 → UHC-61792-31 (Catherine Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002090 | Orphan claim re-pointed Claims processor | CLM-422601 → UHC-15087-09 (Laura Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002091 | Orphan claim re-pointed Claims processor | CLM-420192 → UHC-77831-87 (Wei Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002092 | Orphan claim re-pointed Claims processor | CLM-424587 → UHC-98712-15 (Janice Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002093 | Orphan claim re-pointed Claims processor | CLM-425889 → UHC-90277-38 (Randy Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002094 | Orphan claim re-pointed Claims processor | CLM-423571 → UHC-05661-59 (Megan Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002095 | Orphan claim re-pointed Claims processor | CLM-408319 → UHC-98853-73 (Ray McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002096 | Orphan claim re-pointed Claims processor | CLM-413034 → UHC-41092-13 (Christian Hernanez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002097 | Orphan claim re-pointed Claims processor | CLM-402801 → UHC-54038-88 (Emily Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002098 | Orphan claim re-pointed Claims processor | CLM-421006 → UHC-42579-42 (Adam McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002099 | Orphan claim re-pointed Claims processor | CLM-412239 → UHC-04157-39 (Julie Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002100 | Orphan claim re-pointed Claims processor | CLM-425870 → UHC-86154-31 (Kathleen Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002101 | Orphan claim re-pointed Claims processor | CLM-408573 → UHC-47319-74 (Isabella Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002102 | Orphan claim re-pointed Claims processor | CLM-412910 → UHC-42487-14 (Virginia Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002103 | Orphan claim re-pointed Claims processor | CLM-404650 → UHC-26313-34 (Nicole Smis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002104 | Orphan claim re-pointed Claims processor | CLM-415960 → UHC-36287-89 (Marilyn Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002105 | Orphan claim re-pointed Claims processor | CLM-400976 → UHC-33259-01 (Sean Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002106 | Orphan claim re-pointed Claims processor | CLM-416466 → UHC-05477-22 (Joyce Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002107 | Orphan claim re-pointed Claims processor | CLM-417055 → UHC-69187-33 (Timothy Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002108 | Orphan claim re-pointed Claims processor | CLM-426565 → UHC-32035-80 (Alan Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002109 | Orphan claim re-pointed Claims processor | CLM-407754 → UHC-43635-68 (Albert Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002110 | Orphan claim re-pointed Claims processor | CLM-401977 → UHC-14808-33 (Charles Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002111 | Orphan claim re-pointed Claims processor | CLM-420007 → UHC-19955-99 (Patricia Dixon) |
| 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.