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-002612 | Orphan claim re-pointed Claims processor | CLM-408865 → UHC-20763-80 (Michelle Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002613 | Orphan claim re-pointed Claims processor | CLM-429324 → UHC-62701-47 (Jordan Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002614 | Orphan claim re-pointed Claims processor | CLM-406036 → UHC-76599-05 (Larry Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002615 | Orphan claim re-pointed Claims processor | CLM-431792 → UHC-80014-17 (Diego Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002616 | Orphan claim re-pointed Claims processor | CLM-412137 → UHC-35606-69 (Catherine Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002617 | Orphan claim re-pointed Claims processor | CLM-427918 → UHC-13847-83 (Diego Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002618 | Orphan claim re-pointed Claims processor | CLM-409909 → UHC-84332-87 (Jordan Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002619 | Orphan claim re-pointed Claims processor | CLM-424885 → UHC-64131-81 (Kelly Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002620 | Orphan claim re-pointed Claims processor | CLM-409694 → UHC-88199-27 (Carlos Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002621 | Orphan claim re-pointed Claims processor | CLM-406960 → UHC-40675-56 (Nicole Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002622 | Orphan claim re-pointed Claims processor | CLM-425080 → UHC-20983-31 (Peter Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002623 | Orphan claim re-pointed Claims processor | CLM-415367 → UHC-75069-05 (Daniel Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002624 | Orphan claim re-pointed Claims processor | CLM-430227 → UHC-66078-28 (Aisha Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002625 | Orphan claim re-pointed Claims processor | CLM-426714 → UHC-34406-02 (Patricia Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002626 | Orphan claim re-pointed Claims processor | CLM-413566 → UHC-50765-80 (Kathryn Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002627 | Orphan claim re-pointed Claims processor | CLM-426179 → UHC-26224-70 (Jose Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002628 | Orphan claim re-pointed Claims processor | CLM-425593 → UHC-44943-48 (Sandra Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002629 | Orphan claim re-pointed Claims processor | CLM-405239 → UHC-84143-49 (Anthony Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002630 | Orphan claim re-pointed Claims processor | CLM-410917 → UHC-81632-20 (Teresa Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002631 | Orphan claim re-pointed Claims processor | CLM-420378 → UHC-36461-68 (Sandra Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002632 | Orphan claim re-pointed Claims processor | CLM-400276 → UHC-92974-96 (Alexander Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002633 | Orphan claim re-pointed Claims processor | CLM-419285 → UHC-03266-71 (Amber Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002634 | Orphan claim re-pointed Claims processor | CLM-431822 → UHC-99457-20 (Jess Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002635 | Orphan claim re-pointed Claims processor | CLM-423051 → UHC-16447-67 (Ralph Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002636 | Orphan claim re-pointed Claims processor | CLM-415973 → UHC-40173-47 (Christina Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002637 | Orphan claim re-pointed Claims processor | CLM-405446 → UHC-69418-07 (Cheryl Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002638 | Orphan claim re-pointed Claims processor | CLM-411704 → UHC-50301-63 (Zachary Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002639 | Orphan claim re-pointed Claims processor | CLM-424754 → UHC-17288-43 (Scott Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002640 | Orphan claim re-pointed Claims processor | CLM-402404 → UHC-38979-10 (Anthony Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002641 | Orphan claim re-pointed Claims processor | CLM-426214 → UHC-86599-46 (Nancy Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002642 | Orphan claim re-pointed Claims processor | CLM-403473 → UHC-95401-16 (Kathryn Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002643 | Orphan claim re-pointed Claims processor | CLM-422789 → UHC-54154-91 (Joseph Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002644 | Orphan claim re-pointed Claims processor | CLM-422581 → UHC-99859-68 (Helen Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002645 | Orphan claim re-pointed Claims processor | CLM-423376 → UHC-34873-65 (Jacob Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002646 | Orphan claim re-pointed Claims processor | CLM-401971 → UHC-96149-83 (David Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002647 | Orphan claim re-pointed Claims processor | CLM-409537 → UHC-10812-76 (Beverly Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002648 | Orphan claim re-pointed Claims processor | CLM-408037 → UHC-95096-66 (Scott Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002649 | Orphan claim re-pointed Claims processor | CLM-429779 → UHC-55669-57 (Elizabeth Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002650 | Orphan claim re-pointed Claims processor | CLM-419997 → UHC-67314-03 (Keith Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002651 | Orphan claim re-pointed Claims processor | CLM-407194 → UHC-12421-61 (Emma Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002652 | Orphan claim re-pointed Claims processor | CLM-406357 → UHC-29473-65 (Charlotte Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002653 | Orphan claim re-pointed Claims processor | CLM-406368 → UHC-10686-47 (Carlos Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002654 | Orphan claim re-pointed Claims processor | CLM-428094 → UHC-87638-87 (Melissa Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002655 | Orphan claim re-pointed Claims processor | CLM-423316 → UHC-73613-10 (Willie Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002656 | Orphan claim re-pointed Claims processor | CLM-401516 → UHC-49554-66 (Alice Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002657 | Orphan claim re-pointed Claims processor | CLM-415891 → UHC-84904-40 (Wayne Guarrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002658 | Orphan claim re-pointed Claims processor | CLM-414386 → UHC-37191-06 (Kayla Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002659 | Orphan claim re-pointed Claims processor | CLM-414523 → UHC-44172-99 (Mariana Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002660 | Orphan claim re-pointed Claims processor | CLM-430505 → UHC-78632-10 (Kevin Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002661 | Orphan claim re-pointed Claims processor | CLM-429518 → UHC-80595-34 (Julia Luna) |
| 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.