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-002812 | Orphan claim re-pointed Claims processor | CLM-403080 → UHC-50013-23 (Roy Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002813 | Orphan claim re-pointed Claims processor | CLM-418577 → UHC-44307-53 (Keith Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002814 | Orphan claim re-pointed Claims processor | CLM-422724 → UHC-08766-91 (Catherine Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002815 | Orphan claim re-pointed Claims processor | CLM-406032 → UHC-80888-58 (Wei Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002816 | Orphan claim re-pointed Claims processor | CLM-404444 → UHC-76520-73 (Sandra Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002817 | Orphan claim re-pointed Claims processor | CLM-412415 → UHC-21841-47 (Virginia Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002818 | Orphan claim re-pointed Claims processor | CLM-432748 → UHC-29736-44 (Maria Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002819 | Orphan claim re-pointed Claims processor | CLM-412800 → UHC-28763-39 (Keith Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002820 | Orphan claim re-pointed Claims processor | CLM-414900 → UHC-31468-14 (Wayne Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002821 | Orphan claim re-pointed Claims processor | CLM-409736 → UHC-85355-99 (Christina Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002822 | Orphan claim re-pointed Claims processor | CLM-414043 → UHC-40167-97 (Stephen Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002823 | Orphan claim re-pointed Claims processor | CLM-413472 → UHC-80735-98 (Jonathan Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002824 | Orphan claim re-pointed Claims processor | CLM-426571 → UHC-98914-41 (Terry Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002825 | Orphan claim re-pointed Claims processor | CLM-406429 → UHC-45542-39 (Ashley Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002826 | Orphan claim re-pointed Claims processor | CLM-420614 → UHC-70265-57 (Sandra Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002827 | Orphan claim re-pointed Claims processor | CLM-424600 → UHC-05637-01 (Philip Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002828 | Orphan claim re-pointed Claims processor | CLM-408373 → UHC-21873-56 (Carl Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002829 | Orphan claim re-pointed Claims processor | CLM-413739 → UHC-51134-40 (Bryan Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002830 | Orphan claim re-pointed Claims processor | CLM-411225 → UHC-63213-46 (Donald Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002831 | Orphan claim re-pointed Claims processor | CLM-403520 → UHC-44150-48 (Marcus Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002832 | Orphan claim re-pointed Claims processor | CLM-410213 → UHC-39881-92 (Frances Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002833 | Orphan claim re-pointed Claims processor | CLM-411292 → UHC-84090-92 (Juan Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002834 | Orphan claim re-pointed Claims processor | CLM-419311 → UHC-46372-65 (Melissa Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002835 | Orphan claim re-pointed Claims processor | CLM-402102 → UHC-73034-90 (Jordan Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002836 | Orphan claim re-pointed Claims processor | CLM-405236 → UHC-39201-16 (Robert Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002837 | Orphan claim re-pointed Claims processor | CLM-404765 → UHC-29124-63 (Julie Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002838 | Orphan claim re-pointed Claims processor | CLM-432351 → UHC-83195-17 (Julie Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002839 | Orphan claim re-pointed Claims processor | CLM-427014 → UHC-34653-59 (Madison Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002840 | Orphan claim re-pointed Claims processor | CLM-404349 → UHC-59287-85 (Kathleen Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002841 | Orphan claim re-pointed Claims processor | CLM-404626 → UHC-19839-19 (Evelyn Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002842 | Orphan claim re-pointed Claims processor | CLM-417455 → UHC-25086-59 (Pamela Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002843 | Orphan claim re-pointed Claims processor | CLM-430619 → UHC-23080-10 (Timothy Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002844 | Orphan claim re-pointed Claims processor | CLM-425736 → UHC-69450-62 (Sharon Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002845 | Orphan claim re-pointed Claims processor | CLM-416855 → UHC-92808-15 (Jeffrey Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002846 | Orphan claim re-pointed Claims processor | CLM-427848 → UHC-64161-60 (Sean Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002847 | Orphan claim re-pointed Claims processor | CLM-423925 → UHC-34181-47 (Marcus Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002848 | Orphan claim re-pointed Claims processor | CLM-423133 → UHC-34324-18 (Bruce Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002849 | Orphan claim re-pointed Claims processor | CLM-432601 → UHC-61230-96 (Yuki Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002850 | Orphan claim re-pointed Claims processor | CLM-410656 → UHC-46520-48 (Amanda Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002851 | Orphan claim re-pointed Claims processor | CLM-401272 → UHC-76399-31 (Mason Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002852 | Orphan claim re-pointed Claims processor | CLM-423862 → UHC-97671-82 (Heather Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002853 | Orphan claim re-pointed Claims processor | CLM-408804 → UHC-34202-75 (Mary Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002854 | Orphan claim re-pointed Claims processor | CLM-423670 → UHC-06456-53 (Sharon Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002855 | Orphan claim re-pointed Claims processor | CLM-401972 → UHC-76890-92 (Walter Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002856 | Orphan claim re-pointed Claims processor | CLM-401824 → UHC-49494-33 (Janet Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002857 | Orphan claim re-pointed Claims processor | CLM-420693 → UHC-95700-66 (Juan Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002858 | Orphan claim re-pointed Claims processor | CLM-426991 → UHC-38108-73 (Martha Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002859 | Orphan claim re-pointed Claims processor | CLM-400747 → UHC-89515-83 (Shirley Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002860 | Orphan claim re-pointed Claims processor | CLM-407254 → UHC-52614-08 (Bobby Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002861 | Orphan claim re-pointed Claims processor | CLM-412105 → UHC-97630-84 (Hannah Lawrence) |
| 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.