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-002512 | Orphan claim re-pointed Claims processor | CLM-400132 → UHC-55726-01 (Paul Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002513 | Orphan claim re-pointed Claims processor | CLM-419780 → UHC-40579-79 (Chris Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002514 | Orphan claim re-pointed Claims processor | CLM-415558 → UHC-59146-34 (Russell Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002515 | Orphan claim re-pointed Claims processor | CLM-416695 → UHC-83579-91 (Kimberly Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002516 | Orphan claim re-pointed Claims processor | CLM-429294 → UHC-22780-50 (Barbara Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002517 | Orphan claim re-pointed Claims processor | CLM-421651 → UHC-53180-18 (Mark Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002518 | Orphan claim re-pointed Claims processor | CLM-427359 → UHC-54568-43 (Evelyn Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002519 | Orphan claim re-pointed Claims processor | CLM-427944 → UHC-63689-60 (Nicholas Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002520 | Orphan claim re-pointed Claims processor | CLM-425012 → UHC-78384-87 (Aisha Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002521 | Orphan claim re-pointed Claims processor | CLM-412262 → UHC-76846-30 (Terry Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002522 | Orphan claim re-pointed Claims processor | CLM-414142 → UHC-72994-01 (Raymond Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002523 | Orphan claim re-pointed Claims processor | CLM-425869 → UHC-86154-31 (Kathleen Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002524 | Orphan claim re-pointed Claims processor | CLM-428323 → UHC-04552-01 (Michelle Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002525 | Orphan claim re-pointed Claims processor | CLM-415458 → UHC-89912-12 (Noah Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002526 | Orphan claim re-pointed Claims processor | CLM-416146 → UHC-22101-81 (Harold Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002527 | Orphan claim re-pointed Claims processor | CLM-420425 → UHC-29118-42 (Arjun Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002528 | Orphan claim re-pointed Claims processor | CLM-417930 → UHC-80393-86 (Kenneth Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002529 | Orphan claim re-pointed Claims processor | CLM-404196 → UHC-99236-88 (Elijah Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002530 | Orphan claim re-pointed Claims processor | CLM-415262 → UHC-36016-90 (Edward Olliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002531 | Orphan claim re-pointed Claims processor | CLM-415625 → UHC-25359-26 (Philip Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002532 | Orphan claim re-pointed Claims processor | CLM-424082 → UHC-08861-07 (Margaret Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002533 | Orphan claim re-pointed Claims processor | CLM-405425 → UHC-54662-88 (Brian Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002534 | Orphan claim re-pointed Claims processor | CLM-406458 → UHC-87369-79 (Kenneth Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002535 | Orphan claim re-pointed Claims processor | CLM-410947 → UHC-98661-87 (Christine Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002536 | Orphan claim re-pointed Claims processor | CLM-410937 → UHC-55505-62 (Danielle Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002537 | Orphan claim re-pointed Claims processor | CLM-412457 → UHC-08495-02 (Cynthia Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002538 | Orphan claim re-pointed Claims processor | CLM-425958 → UHC-09753-41 (Robert Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002539 | Orphan claim re-pointed Claims processor | CLM-419106 → UHC-65879-07 (Gregory Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002540 | Orphan claim re-pointed Claims processor | CLM-419471 → UHC-05418-33 (Kimberly Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002541 | Orphan claim re-pointed Claims processor | CLM-410484 → UHC-98537-14 (Carolyn Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002542 | Orphan claim re-pointed Claims processor | CLM-422125 → UHC-14764-41 (Donald Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002543 | Orphan claim re-pointed Claims processor | CLM-431865 → UHC-57256-57 (Lawrence Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002544 | Orphan claim re-pointed Claims processor | CLM-427330 → UHC-27163-89 (Alexander Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002545 | Orphan claim re-pointed Claims processor | CLM-421587 → UHC-56787-59 (Doris Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002546 | Orphan claim re-pointed Claims processor | CLM-428962 → UHC-48005-22 (Yuki Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002547 | Orphan claim re-pointed Claims processor | CLM-427497 → UHC-98629-39 (Logan Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002548 | Orphan claim re-pointed Claims processor | CLM-424389 → UHC-74662-82 (Sofia Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002549 | Orphan claim re-pointed Claims processor | CLM-404105 → UHC-74272-06 (Zachary Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002550 | Orphan claim re-pointed Claims processor | CLM-401313 → UHC-98286-73 (Ahmed Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002551 | Orphan claim re-pointed Claims processor | CLM-426268 → UHC-56034-71 (Bryan Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002552 | Orphan claim re-pointed Claims processor | CLM-411579 → UHC-76995-58 (Elijah Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002553 | Orphan claim re-pointed Claims processor | CLM-416066 → UHC-64534-54 (Jeffrey Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002554 | Orphan claim re-pointed Claims processor | CLM-415515 → UHC-43588-39 (Keith Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002555 | Orphan claim re-pointed Claims processor | CLM-426114 → UHC-85304-86 (James Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002556 | Orphan claim re-pointed Claims processor | CLM-430815 → UHC-56570-23 (Diego Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002557 | Orphan claim re-pointed Claims processor | CLM-429679 → UHC-60673-74 (Julie Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002558 | Orphan claim re-pointed Claims processor | CLM-403803 → UHC-96623-89 (Ryan Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002559 | Orphan claim re-pointed Claims processor | CLM-417291 → UHC-99756-43 (Jacob Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002560 | Orphan claim re-pointed Claims processor | CLM-422234 → UHC-27302-30 (Marilyn West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002561 | Orphan claim re-pointed Claims processor | CLM-419379 → UHC-85432-06 (Albert Ellis) |
| 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.