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-002262 | Orphan claim re-pointed Claims processor | CLM-413797 → UHC-86977-16 (Matthew Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002263 | Orphan claim re-pointed Claims processor | CLM-426875 → UHC-95535-50 (Henry Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002264 | Orphan claim re-pointed Claims processor | CLM-430656 → UHC-52639-52 (Valentina White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002265 | Orphan claim re-pointed Claims processor | CLM-403429 → UHC-86878-50 (Aisha Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002266 | Orphan claim re-pointed Claims processor | CLM-409998 → UHC-20829-55 (Pamela Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002267 | Orphan claim re-pointed Claims processor | CLM-410582 → UHC-72826-07 (Walter Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002268 | Orphan claim re-pointed Claims processor | CLM-406289 → UHC-75403-09 (Judy Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002269 | Orphan claim re-pointed Claims processor | CLM-406745 → UHC-77558-15 (Patricia Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002270 | Orphan claim re-pointed Claims processor | CLM-428133 → UHC-27972-26 (Jack Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002271 | Orphan claim re-pointed Claims processor | CLM-415304 → UHC-73297-66 (Amy Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002272 | Orphan claim re-pointed Claims processor | CLM-408446 → UHC-42065-41 (Alice Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002273 | Orphan claim re-pointed Claims processor | CLM-414979 → UHC-18151-08 (Diego Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002274 | Orphan claim re-pointed Claims processor | CLM-428851 → UHC-62466-60 (Nancy Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002275 | Orphan claim re-pointed Claims processor | CLM-421316 → UHC-24208-80 (Abigail Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002276 | Orphan claim re-pointed Claims processor | CLM-401522 → UHC-28393-22 (Denise Petesr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002277 | Orphan claim re-pointed Claims processor | CLM-419781 → UHC-40579-79 (Chris Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002278 | Orphan claim re-pointed Claims processor | CLM-420871 → UHC-07640-06 (Donna Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002279 | Orphan claim re-pointed Claims processor | CLM-423039 → UHC-28932-50 (Christina Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002280 | Orphan claim re-pointed Claims processor | CLM-408621 → UHC-33957-43 (Kyle Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002281 | Orphan claim re-pointed Claims processor | CLM-401178 → UHC-29262-82 (Mark Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002282 | Orphan claim re-pointed Claims processor | CLM-401214 → UHC-22994-76 (Carl Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002283 | Orphan claim re-pointed Claims processor | CLM-427858 → UHC-70759-17 (Bradley Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002284 | Orphan claim re-pointed Claims processor | CLM-406596 → UHC-02077-12 (Hiroshi Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002285 | Orphan claim re-pointed Claims processor | CLM-422439 → UHC-22819-36 (Emma Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002286 | Orphan claim re-pointed Claims processor | CLM-401421 → UHC-10593-35 (Heather Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002287 | Orphan claim re-pointed Claims processor | CLM-407141 → UHC-38908-32 (Mateo Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002288 | Orphan claim re-pointed Claims processor | CLM-421177 → UHC-73240-85 (Willie Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002289 | Orphan claim re-pointed Claims processor | CLM-420877 → UHC-22366-98 (Kenneth Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002290 | Orphan claim re-pointed Claims processor | CLM-402391 → UHC-47202-05 (Justin Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002291 | Orphan claim re-pointed Claims processor | CLM-430979 → UHC-47494-97 (Karen Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002292 | Orphan claim re-pointed Claims processor | CLM-427173 → UHC-11439-98 (Bryan Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002293 | Orphan claim re-pointed Claims processor | CLM-426667 → UHC-71604-82 (Ana Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002294 | Orphan claim re-pointed Claims processor | CLM-424889 → UHC-61480-16 (Aishha Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002295 | Orphan claim re-pointed Claims processor | CLM-408669 → UHC-47109-24 (Ruth Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002296 | Orphan claim re-pointed Claims processor | CLM-413554 → UHC-81029-42 (Deborah Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002297 | Orphan claim re-pointed Claims processor | CLM-404227 → UHC-38360-46 (Jean Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002298 | Orphan claim re-pointed Claims processor | CLM-403609 → UHC-77954-08 (Robert Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002299 | Orphan claim re-pointed Claims processor | CLM-423092 → UHC-11916-11 (Amber Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002300 | Orphan claim re-pointed Claims processor | CLM-405069 → UHC-72077-72 (Alan Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002301 | Orphan claim re-pointed Claims processor | CLM-401948 → UHC-41084-85 (Ralph Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002302 | Orphan claim re-pointed Claims processor | CLM-423765 → UHC-74068-29 (Margaret Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002303 | Orphan claim re-pointed Claims processor | CLM-400967 → UHC-99845-01 (Joseph Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002304 | Orphan claim re-pointed Claims processor | CLM-424895 → UHC-23833-14 (Frank Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002305 | Orphan claim re-pointed Claims processor | CLM-405450 → UHC-99272-28 (Jacob McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002306 | Orphan claim re-pointed Claims processor | CLM-400398 → UHC-54640-63 (Shirley Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002307 | Orphan claim re-pointed Claims processor | CLM-412938 → UHC-56397-77 (Emma Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002308 | Orphan claim re-pointed Claims processor | CLM-424382 → UHC-28200-70 (Richard Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002309 | Orphan claim re-pointed Claims processor | CLM-415273 → UHC-94929-40 (Kimberly Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002310 | Orphan claim re-pointed Claims processor | CLM-420571 → UHC-70228-56 (Linda McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002311 | Orphan claim re-pointed Claims processor | CLM-428232 → UHC-45079-43 (Jerry Dunn) |
| 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.