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-010340 | Orphan claim re-pointed Claims processor | CLM-424371 → UHC-51097-26 (Roger Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010341 | Orphan claim re-pointed Claims processor | CLM-406034 → UHC-48655-61 (Maria Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010342 | Orphan claim re-pointed Claims processor | CLM-415476 → UHC-34102-43 (Paul Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010343 | Orphan claim re-pointed Claims processor | CLM-413873 → UHC-53988-81 (Teresa Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010344 | Orphan claim re-pointed Claims processor | CLM-406700 → UHC-64707-24 (Mary Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010345 | Orphan claim re-pointed Claims processor | CLM-419663 → UHC-58484-01 (Beverly Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010346 | Orphan claim re-pointed Claims processor | CLM-427985 → UHC-90343-90 (Elijah Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010347 | Orphan claim re-pointed Claims processor | CLM-405351 → UHC-72880-67 (Barbara Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010348 | Orphan claim re-pointed Claims processor | CLM-407800 → UHC-31792-15 (Lisa Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010349 | Orphan claim re-pointed Claims processor | CLM-410888 → UHC-63529-48 (Hannah Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010350 | Orphan claim re-pointed Claims processor | CLM-401300 → UHC-33261-46 (Vincet Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010351 | Orphan claim re-pointed Claims processor | CLM-414522 → UHC-46817-61 (Mateo Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010352 | Orphan claim re-pointed Claims processor | CLM-401853 → UHC-58248-42 (Edward Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010353 | Orphan claim re-pointed Claims processor | CLM-406763 → UHC-30409-08 (Kathy Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010354 | Orphan claim re-pointed Claims processor | CLM-425969 → UHC-84938-93 (Sophia Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010355 | Orphan claim re-pointed Claims processor | CLM-407583 → UHC-33507-83 (Joe Welkh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010356 | Orphan claim re-pointed Claims processor | CLM-424415 → UHC-85600-23 (Noah Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010357 | Orphan claim re-pointed Claims processor | CLM-407915 → UHC-74491-09 (Gabriel Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010358 | Orphan claim re-pointed Claims processor | CLM-422719 → UHC-39775-45 (Bobby Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010359 | Orphan claim re-pointed Claims processor | CLM-406313 → UHC-37922-39 (Cheryl Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010360 | Orphan claim re-pointed Claims processor | CLM-412620 → UHC-67711-06 (Christina Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010361 | Orphan claim re-pointed Claims processor | CLM-406186 → UHC-18080-63 (Eugene Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010362 | Orphan claim re-pointed Claims processor | CLM-429462 → UHC-53838-39 (Lucia Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010363 | Orphan claim re-pointed Claims processor | CLM-427111 → UHC-98826-91 (Isabella Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010364 | Orphan claim re-pointed Claims processor | CLM-404549 → UHC-96000-34 (Teresa Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010365 | Orphan claim re-pointed Claims processor | CLM-430125 → UHC-30205-72 (Mariana Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010366 | Orphan claim re-pointed Claims processor | CLM-432013 → UHC-49736-25 (Doris Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010367 | Orphan claim re-pointed Claims processor | CLM-417662 → UHC-99615-18 (Mark Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010368 | Orphan claim re-pointed Claims processor | CLM-408028 → UHC-48323-60 (Nicholas Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010369 | Orphan claim re-pointed Claims processor | CLM-404094 → UHC-37776-09 (Anna Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010370 | Orphan claim re-pointed Claims processor | CLM-417085 → UHC-35055-31 (Alice Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010371 | Orphan claim re-pointed Claims processor | CLM-418967 → UHC-02731-78 (Charles Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010372 | Orphan claim re-pointed Claims processor | CLM-406243 → UHC-68255-89 (Jeremy Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010373 | Orphan claim re-pointed Claims processor | CLM-412609 → UHC-08541-69 (Sandra Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010374 | Orphan claim re-pointed Claims processor | CLM-422646 → UHC-19675-29 (Philip Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010375 | Orphan claim re-pointed Claims processor | CLM-422311 → UHC-37542-71 (Vincent Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010376 | Orphan claim re-pointed Claims processor | CLM-425995 → UHC-36504-88 (Diego Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010377 | Orphan claim re-pointed Claims processor | CLM-410643 → UHC-13303-97 (Rachel Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010378 | Orphan claim re-pointed Claims processor | CLM-419201 → UHC-40453-51 (Kyle Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010379 | Orphan claim re-pointed Claims processor | CLM-426763 → UHC-93876-66 (Brian Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010380 | Orphan claim re-pointed Claims processor | CLM-416997 → UHC-76184-54 (Abigail Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010381 | Orphan claim re-pointed Claims processor | CLM-412606 → UHC-28401-72 (Lori Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010382 | Orphan claim re-pointed Claims processor | CLM-420826 → UHC-93150-43 (George Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010383 | Orphan claim re-pointed Claims processor | CLM-403251 → UHC-01029-95 (Jack Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010384 | Orphan claim re-pointed Claims processor | CLM-432785 → UHC-12321-25 (Tyler Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010385 | Orphan claim re-pointed Claims processor | CLM-404900 → UHC-27948-29 (Zachary Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010386 | Orphan claim re-pointed Claims processor | CLM-405146 → UHC-91196-41 (Emma Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010387 | Orphan claim re-pointed Claims processor | CLM-421244 → UHC-67909-78 (Martha Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010388 | Orphan claim re-pointed Claims processor | CLM-400101 → UHC-16651-46 (Josh Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-010389 | Orphan claim re-pointed Claims processor | CLM-403571 → UHC-27047-16 (Karen Diaz) |
| 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.