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-002312 | Orphan claim re-pointed Claims processor | CLM-407330 → UHC-05201-04 (Willie Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002313 | Orphan claim re-pointed Claims processor | CLM-427520 → UHC-98167-09 (Albert Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002314 | Orphan claim re-pointed Claims processor | CLM-415640 → UHC-85530-87 (Ronald Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002315 | Orphan claim re-pointed Claims processor | CLM-401744 → UHC-06356-65 (Bradley Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002316 | Orphan claim re-pointed Claims processor | CLM-417771 → UHC-16715-78 (Amy Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002317 | Orphan claim re-pointed Claims processor | CLM-405598 → UHC-90677-97 (Mason Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002318 | Orphan claim re-pointed Claims processor | CLM-428897 → UHC-33334-49 (Brittany Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002319 | Orphan claim re-pointed Claims processor | CLM-416861 → UHC-21154-82 (David Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002320 | Orphan claim re-pointed Claims processor | CLM-404082 → UHC-64825-97 (Ana Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002321 | Orphan claim re-pointed Claims processor | CLM-416180 → UHC-37217-39 (Thomas Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002322 | Orphan claim re-pointed Claims processor | CLM-409910 → UHC-84332-87 (Jordan Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002323 | Orphan claim re-pointed Claims processor | CLM-427859 → UHC-70759-17 (Bradley Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002324 | Orphan claim re-pointed Claims processor | CLM-424939 → UHC-82777-29 (Diane Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002325 | Orphan claim re-pointed Claims processor | CLM-405167 → UHC-12186-67 (Richard Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002326 | Orphan claim re-pointed Claims processor | CLM-426056 → UHC-28432-36 (Ruth Peez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002327 | Orphan claim re-pointed Claims processor | CLM-415958 → UHC-59669-36 (Joan Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002328 | Orphan claim re-pointed Claims processor | CLM-406232 → UHC-00189-24 (Victoria Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002329 | Orphan claim re-pointed Claims processor | CLM-413560 → UHC-46150-37 (Cheryl Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002330 | Orphan claim re-pointed Claims processor | CLM-409045 → UHC-09446-73 (Doris Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002331 | Orphan claim re-pointed Claims processor | CLM-417022 → UHC-08427-88 (Peter Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002332 | Orphan claim re-pointed Claims processor | CLM-423300 → UHC-37027-49 (Sofia Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002333 | Orphan claim re-pointed Claims processor | CLM-427393 → UHC-15905-97 (Madison Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002334 | Orphan claim re-pointed Claims processor | CLM-411375 → UHC-85505-93 (Heather Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002335 | Orphan claim re-pointed Claims processor | CLM-421864 → UHC-92156-95 (Harold Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002336 | Orphan claim re-pointed Claims processor | CLM-404972 → UHC-78928-58 (Don Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002337 | Orphan claim re-pointed Claims processor | CLM-415166 → UHC-08541-87 (Daniel Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002338 | Orphan claim re-pointed Claims processor | CLM-418811 → UHC-55168-96 (Alice Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002339 | Orphan claim re-pointed Claims processor | CLM-401938 → UHC-26954-37 (Katherine Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002340 | Orphan claim re-pointed Claims processor | CLM-416609 → UHC-99673-23 (Brandon Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002341 | Orphan claim re-pointed Claims processor | CLM-401307 → UHC-72865-77 (Lisa Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002342 | Orphan claim re-pointed Claims processor | CLM-421274 → UHC-78003-20 (Janet Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002343 | Orphan claim re-pointed Claims processor | CLM-423755 → UHC-13092-60 (Philip Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002344 | Orphan claim re-pointed Claims processor | CLM-425911 → UHC-33764-63 (Aisha Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002345 | Orphan claim re-pointed Claims processor | CLM-421038 → UHC-85134-32 (Evelyn Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002346 | Orphan claim re-pointed Claims processor | CLM-429627 → UHC-43306-46 (Ruth Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002347 | Orphan claim re-pointed Claims processor | CLM-401104 → UHC-12085-61 (Kathryn Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002348 | Orphan claim re-pointed Claims processor | CLM-428361 → UHC-84690-46 (Bradley Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002349 | Orphan claim re-pointed Claims processor | CLM-416128 → UHC-84057-85 (George Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002350 | Orphan claim re-pointed Claims processor | CLM-430573 → UHC-68224-02 (Ruth Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002351 | Orphan claim re-pointed Claims processor | CLM-417248 → UHC-89202-61 (Russell Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002352 | Orphan claim re-pointed Claims processor | CLM-420695 → UHC-23729-08 (Karen Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002353 | Orphan claim re-pointed Claims processor | CLM-416109 → UHC-25752-79 (Ruth Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002354 | Orphan claim re-pointed Claims processor | CLM-428439 → UHC-06884-65 (Tyler Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002355 | Orphan claim re-pointed Claims processor | CLM-431800 → UHC-08571-74 (Judy Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002356 | Orphan claim re-pointed Claims processor | CLM-416900 → UHC-69945-91 (Douglas Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002357 | Orphan claim re-pointed Claims processor | CLM-412836 → UHC-32565-66 (Arjun Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002358 | Orphan claim re-pointed Claims processor | CLM-421867 → UHC-33583-79 (Noah Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002359 | Orphan claim re-pointed Claims processor | CLM-422823 → UHC-58222-55 (Benjamin Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002360 | Orphan claim re-pointed Claims processor | CLM-405382 → UHC-26745-33 (Arjun Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002361 | Orphan claim re-pointed Claims processor | CLM-409036 → UHC-06691-69 (Joyce Patterson) |
| 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.