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-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 | ||
| ACT-002240 | Orphan claim re-pointed Claims processor | CLM-430396 → UHC-43705-52 (Margaret Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002241 | Orphan claim re-pointed Claims processor | CLM-411937 → UHC-39559-25 (Keith Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002242 | Orphan claim re-pointed Claims processor | CLM-425751 → UHC-12395-95 (Nicole Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002243 | Orphan claim re-pointed Claims processor | CLM-408224 → UHC-56619-38 (Sarah Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002244 | Orphan claim re-pointed Claims processor | CLM-410429 → UHC-36655-13 (Anna Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002245 | Orphan claim re-pointed Claims processor | CLM-428446 → UHC-66752-04 (Michael Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002246 | Orphan claim re-pointed Claims processor | CLM-414399 → UHC-11000-88 (Julie Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002247 | Orphan claim re-pointed Claims processor | CLM-427509 → UHC-79109-70 (Arthur Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002248 | Orphan claim re-pointed Claims processor | CLM-413830 → UHC-49708-56 (Karen Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002249 | Orphan claim re-pointed Claims processor | CLM-414520 → UHC-46817-61 (Mateo Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002250 | Orphan claim re-pointed Claims processor | CLM-426755 → UHC-35632-44 (Walter Benntt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002251 | Orphan claim re-pointed Claims processor | CLM-416657 → UHC-21051-13 (Judith Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002252 | Orphan claim re-pointed Claims processor | CLM-402908 → UHC-56867-96 (Peter Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002253 | Orphan claim re-pointed Claims processor | CLM-416512 → UHC-92965-58 (Anthony Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002254 | Orphan claim re-pointed Claims processor | CLM-418287 → UHC-71635-91 (Natalie Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002255 | Orphan claim re-pointed Claims processor | CLM-410415 → UHC-25697-06 (Theresa Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002256 | Orphan claim re-pointed Claims processor | CLM-420347 → UHC-55251-71 (Mateo Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002257 | Orphan claim re-pointed Claims processor | CLM-428177 → UHC-35334-30 (Jerry Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002258 | Orphan claim re-pointed Claims processor | CLM-403555 → UHC-08946-09 (Marilyn Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002259 | Orphan claim re-pointed Claims processor | CLM-422518 → UHC-10447-33 (Alice Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002260 | Orphan claim re-pointed Claims processor | CLM-429270 → UHC-12979-32 (Amanda Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002261 | Orphan claim re-pointed Claims processor | CLM-407768 → UHC-21146-15 (Glria Black) |
| 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.