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-002112 | Orphan claim re-pointed Claims processor | CLM-415045 → UHC-05367-86 (Carolyn Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002113 | Orphan claim re-pointed Claims processor | CLM-408242 → UHC-40407-79 (Doris Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002114 | Orphan claim re-pointed Claims processor | CLM-429747 → UHC-18434-28 (Lauren Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002115 | Orphan claim re-pointed Claims processor | CLM-423424 → UHC-98614-28 (Elijah Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002116 | Orphan claim re-pointed Claims processor | CLM-406239 → UHC-47679-95 (Sharon Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002117 | Orphan claim re-pointed Claims processor | CLM-401148 → UHC-11161-09 (Victoria Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002118 | Orphan claim re-pointed Claims processor | CLM-428747 → UHC-37323-32 (Peter Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002119 | Orphan claim re-pointed Claims processor | CLM-431705 → UHC-56875-41 (Christine Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002120 | Orphan claim re-pointed Claims processor | CLM-422215 → UHC-02831-95 (Yuki Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002121 | Orphan claim re-pointed Claims processor | CLM-411349 → UHC-31410-22 (Alexander Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002122 | Orphan claim re-pointed Claims processor | CLM-428028 → UHC-86087-23 (Benjamin Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002123 | Orphan claim re-pointed Claims processor | CLM-429598 → UHC-20820-88 (Mary Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002124 | Orphan claim re-pointed Claims processor | CLM-412229 → UHC-91956-26 (Yuki King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002125 | Orphan claim re-pointed Claims processor | CLM-431927 → UHC-04180-39 (Isabella White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002126 | Orphan claim re-pointed Claims processor | CLM-408083 → UHC-10379-19 (Randy Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002127 | Orphan claim re-pointed Claims processor | CLM-415821 → UHC-64116-48 (Jeremy Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002128 | Orphan claim re-pointed Claims processor | CLM-419972 → UHC-47074-60 (Bobby Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002129 | Orphan claim re-pointed Claims processor | CLM-410254 → UHC-10287-51 (Frank Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002130 | Orphan claim re-pointed Claims processor | CLM-403534 → UHC-30904-19 (Kevin Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002131 | Orphan claim re-pointed Claims processor | CLM-413447 → UHC-15252-88 (Emily Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002132 | Orphan claim re-pointed Claims processor | CLM-422898 → UHC-30425-67 (Betty Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002133 | Orphan claim re-pointed Claims processor | CLM-410337 → UHC-62319-26 (Evelyn McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002134 | Orphan claim re-pointed Claims processor | CLM-401594 → UHC-17637-46 (Timothy Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002135 | Orphan claim re-pointed Claims processor | CLM-405284 → UHC-05707-46 (Laura Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002136 | Orphan claim re-pointed Claims processor | CLM-418683 → UHC-35354-11 (William Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002137 | Orphan claim re-pointed Claims processor | CLM-429426 → UHC-77088-92 (Gregory Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002138 | Orphan claim re-pointed Claims processor | CLM-426237 → UHC-28109-74 (Burce Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002139 | Orphan claim re-pointed Claims processor | CLM-431180 → UHC-58544-19 (Carolyn George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002140 | Orphan claim re-pointed Claims processor | CLM-422674 → UHC-21918-10 (Kathryn Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002141 | Orphan claim re-pointed Claims processor | CLM-421679 → UHC-45856-82 (Yuki Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002142 | Orphan claim re-pointed Claims processor | CLM-406930 → UHC-22861-84 (Rebecca Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002143 | Orphan claim re-pointed Claims processor | CLM-405611 → UHC-44784-71 (Mariana Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002144 | Orphan claim re-pointed Claims processor | CLM-413806 → UHC-34240-65 (Willie Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002145 | Orphan claim re-pointed Claims processor | CLM-415856 → UHC-00613-40 (Tyler Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002146 | Orphan claim re-pointed Claims processor | CLM-423949 → UHC-91976-08 (Raymond Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002147 | Orphan claim re-pointed Claims processor | CLM-408658 → UHC-37053-26 (Priya Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002148 | Orphan claim re-pointed Claims processor | CLM-417777 → UHC-35103-42 (Henry Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002149 | Orphan claim re-pointed Claims processor | CLM-411149 → UHC-28541-33 (Noah Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002150 | Orphan claim re-pointed Claims processor | CLM-421900 → UHC-80433-48 (Alexis Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002151 | Orphan claim re-pointed Claims processor | CLM-425354 → UHC-10902-28 (Mason Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002152 | Orphan claim re-pointed Claims processor | CLM-404698 → UHC-76713-41 (Brenda Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002153 | Orphan claim re-pointed Claims processor | CLM-429948 → UHC-28727-85 (Frances Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002154 | Orphan claim re-pointed Claims processor | CLM-407591 → UHC-56547-09 (Elizabeth Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002155 | Orphan claim re-pointed Claims processor | CLM-414088 → UHC-63894-92 (Tyler Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002156 | Orphan claim re-pointed Claims processor | CLM-431075 → UHC-00720-73 (Brenda Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002157 | Orphan claim re-pointed Claims processor | CLM-409618 → UHC-70330-92 (Albert Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002158 | Orphan claim re-pointed Claims processor | CLM-409575 → UHC-33964-15 (Heather Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002159 | Orphan claim re-pointed Claims processor | CLM-431505 → UHC-05977-75 (Chris Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002160 | Orphan claim re-pointed Claims processor | CLM-421866 → UHC-74984-66 (Nancy Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002161 | Orphan claim re-pointed Claims processor | CLM-432287 → UHC-44700-43 (Denise Mills) |
| 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.