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-002762 | Orphan claim re-pointed Claims processor | CLM-408867 → UHC-03470-58 (George Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002763 | Orphan claim re-pointed Claims processor | CLM-419274 → UHC-51195-87 (Kelly Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002764 | Orphan claim re-pointed Claims processor | CLM-428978 → UHC-20430-89 (Julia Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002765 | Orphan claim re-pointed Claims processor | CLM-402952 → UHC-52045-15 (Linda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002766 | Orphan claim re-pointed Claims processor | CLM-420603 → UHC-33706-77 (Bryan Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002767 | Orphan claim re-pointed Claims processor | CLM-421601 → UHC-05399-64 (Shirley Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002768 | Orphan claim re-pointed Claims processor | CLM-407019 → UHC-48679-36 (David Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002769 | Orphan claim re-pointed Claims processor | CLM-425431 → UHC-14829-62 (Larry Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002770 | Orphan claim re-pointed Claims processor | CLM-421484 → UHC-06965-04 (Noah Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002771 | Orphan claim re-pointed Claims processor | CLM-422783 → UHC-17335-35 (Eric Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002772 | Orphan claim re-pointed Claims processor | CLM-424102 → UHC-36356-27 (Edward George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002773 | Orphan claim re-pointed Claims processor | CLM-415152 → UHC-65736-97 (Cynthia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002774 | Orphan claim re-pointed Claims processor | CLM-427615 → UHC-70116-01 (Matthew Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002775 | Orphan claim re-pointed Claims processor | CLM-427100 → UHC-63226-44 (Timothy Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002776 | Orphan claim re-pointed Claims processor | CLM-417083 → UHC-05458-06 (Theresa Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002777 | Orphan claim re-pointed Claims processor | CLM-426786 → UHC-75200-93 (Angela Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002778 | Orphan claim re-pointed Claims processor | CLM-407263 → UHC-05853-23 (Thomas Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002779 | Orphan claim re-pointed Claims processor | CLM-426182 → UHC-01358-75 (Kevin Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002780 | Orphan claim re-pointed Claims processor | CLM-432126 → UHC-30484-31 (Raymond Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002781 | Orphan claim re-pointed Claims processor | CLM-423972 → UHC-90465-53 (Isabella Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002782 | Orphan claim re-pointed Claims processor | CLM-430210 → UHC-63930-87 (Alan Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002783 | Orphan claim re-pointed Claims processor | CLM-402562 → UHC-84832-60 (Melissa Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002784 | Orphan claim re-pointed Claims processor | CLM-428295 → UHC-94402-84 (Anna Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002785 | Orphan claim re-pointed Claims processor | CLM-429082 → UHC-44841-77 (Lawrence Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002786 | Orphan claim re-pointed Claims processor | CLM-423108 → UHC-04176-72 (Raymond Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002787 | Orphan claim re-pointed Claims processor | CLM-405530 → UHC-66614-26 (Denise Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002788 | Orphan claim re-pointed Claims processor | CLM-422681 → UHC-21693-90 (Dylan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002789 | Orphan claim re-pointed Claims processor | CLM-407916 → UHC-74491-09 (Gabriel Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002790 | Orphan claim re-pointed Claims processor | CLM-404255 → UHC-47728-62 (Jordan Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002791 | Orphan claim re-pointed Claims processor | CLM-405930 → UHC-41376-70 (Michael Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002792 | Orphan claim re-pointed Claims processor | CLM-432598 → UHC-33766-76 (Joyce Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002793 | Orphan claim re-pointed Claims processor | CLM-407619 → UHC-68405-99 (Timothy Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002794 | Orphan claim re-pointed Claims processor | CLM-414103 → UHC-91321-72 (Amanda Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002795 | Orphan claim re-pointed Claims processor | CLM-432154 → UHC-76846-41 (Kelly Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002796 | Orphan claim re-pointed Claims processor | CLM-429911 → UHC-14773-40 (Angela Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002797 | Orphan claim re-pointed Claims processor | CLM-411432 → UHC-06434-75 (Harold Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002798 | Orphan claim re-pointed Claims processor | CLM-426328 → UHC-26756-01 (Frank Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002799 | Orphan claim re-pointed Claims processor | CLM-422359 → UHC-07385-60 (Nancy Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002800 | Orphan claim re-pointed Claims processor | CLM-426106 → UHC-27206-41 (Rachel Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002801 | Orphan claim re-pointed Claims processor | CLM-410278 → UHC-87261-18 (Angela Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002802 | Orphan claim re-pointed Claims processor | CLM-413383 → UHC-39437-35 (Robert Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002803 | Orphan claim re-pointed Claims processor | CLM-400157 → UHC-61957-49 (Mateo Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002804 | Orphan claim re-pointed Claims processor | CLM-430272 → UHC-76821-72 (Paul Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002805 | Orphan claim re-pointed Claims processor | CLM-420539 → UHC-35602-95 (Frank Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002806 | Orphan claim re-pointed Claims processor | CLM-425656 → UHC-82804-57 (Jack Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002807 | Orphan claim re-pointed Claims processor | CLM-428598 → UHC-17486-80 (Donald Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002808 | Orphan claim re-pointed Claims processor | CLM-414089 → UHC-63894-92 (Tyler Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002809 | Orphan claim re-pointed Claims processor | CLM-417892 → UHC-17587-12 (Justin Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002810 | Orphan claim re-pointed Claims processor | CLM-414592 → UHC-63679-21 (Kevin George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002811 | Orphan claim re-pointed Claims processor | CLM-407453 → UHC-82007-66 (Jose Reyes) |
| 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.