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-002162 | Orphan claim re-pointed Claims processor | CLM-429323 → UHC-62701-47 (Jordan Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002163 | Orphan claim re-pointed Claims processor | CLM-425453 → UHC-52419-70 (Scott Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002164 | Orphan claim re-pointed Claims processor | CLM-414936 → UHC-40253-88 (Tyler Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002165 | Orphan claim re-pointed Claims processor | CLM-430762 → UHC-62292-08 (Zachary Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002166 | Orphan claim re-pointed Claims processor | CLM-426278 → UHC-34666-58 (Nancy Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002167 | Orphan claim re-pointed Claims processor | CLM-401275 → UHC-69783-42 (Mark McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002168 | Orphan claim re-pointed Claims processor | CLM-405796 → UHC-11088-69 (Jordan Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002169 | Orphan claim re-pointed Claims processor | CLM-424277 → UHC-22202-05 (Deborah Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002170 | Orphan claim re-pointed Claims processor | CLM-417558 → UHC-84776-24 (Denise Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002171 | Orphan claim re-pointed Claims processor | CLM-431731 → UHC-88301-75 (Elizabeth Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002172 | Orphan claim re-pointed Claims processor | CLM-404057 → UHC-88620-95 (Roger Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002173 | Orphan claim re-pointed Claims processor | CLM-409049 → UHC-45658-13 (Thomas Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002174 | Orphan claim re-pointed Claims processor | CLM-404773 → UHC-89097-26 (Michael Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002175 | Orphan claim re-pointed Claims processor | CLM-406927 → UHC-06484-78 (Matthew Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002176 | Orphan claim re-pointed Claims processor | CLM-409589 → UHC-00556-15 (Adam Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002177 | Orphan claim re-pointed Claims processor | CLM-429562 → UHC-07193-28 (Stephanie Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002178 | Orphan claim re-pointed Claims processor | CLM-426711 → UHC-10317-87 (Charles Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002179 | Orphan claim re-pointed Claims processor | CLM-425856 → UHC-24843-71 (Priya Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002180 | Orphan claim re-pointed Claims processor | CLM-412531 → UHC-77548-67 (Karen Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002181 | Orphan claim re-pointed Claims processor | CLM-405950 → UHC-91434-86 (Joe Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002182 | Orphan claim re-pointed Claims processor | CLM-410106 → UHC-56842-65 (Abigail Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002183 | Orphan claim re-pointed Claims processor | CLM-410400 → UHC-45904-17 (Ana Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002184 | Orphan claim re-pointed Claims processor | CLM-401676 → UHC-67952-09 (Brian Syder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002185 | Orphan claim re-pointed Claims processor | CLM-417217 → UHC-54423-95 (Katherine Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002186 | Orphan claim re-pointed Claims processor | CLM-427376 → UHC-37268-78 (Ana Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002187 | Orphan claim re-pointed Claims processor | CLM-404333 → UHC-41797-44 (Sharon Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002188 | Orphan claim re-pointed Claims processor | CLM-414107 → UHC-60096-29 (Water Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002189 | Orphan claim re-pointed Claims processor | CLM-425604 → UHC-75343-29 (Lauren Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| 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 |
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.