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-002862 | Orphan claim re-pointed Claims processor | CLM-413221 → UHC-82132-71 (Janice Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002863 | Orphan claim re-pointed Claims processor | CLM-417984 → UHC-74487-51 (Christine Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002864 | Orphan claim re-pointed Claims processor | CLM-413927 → UHC-29180-53 (Sean Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002865 | Orphan claim re-pointed Claims processor | CLM-429285 → UHC-12005-81 (Samantha Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002866 | Orphan claim re-pointed Claims processor | CLM-423502 → UHC-29410-17 (David Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002867 | Orphan claim re-pointed Claims processor | CLM-423559 → UHC-87270-42 (David Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002868 | Orphan claim re-pointed Claims processor | CLM-417483 → UHC-28858-52 (Amber Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002869 | Orphan claim re-pointed Claims processor | CLM-400323 → UHC-70030-79 (Peter Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002870 | Orphan claim re-pointed Claims processor | CLM-414431 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002871 | Orphan claim re-pointed Claims processor | CLM-424697 → UHC-50069-87 (Barbara Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002872 | Orphan claim re-pointed Claims processor | CLM-425873 → UHC-61450-81 (Judy Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002873 | Orphan claim re-pointed Claims processor | CLM-432264 → UHC-24573-21 (Bryan Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002874 | Orphan claim re-pointed Claims processor | CLM-409287 → UHC-66382-01 (Juan Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002875 | Orphan claim re-pointed Claims processor | CLM-410200 → UHC-71115-60 (Danielle Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002876 | Orphan claim re-pointed Claims processor | CLM-425510 → UHC-17694-70 (Aaron Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002877 | Orphan claim re-pointed Claims processor | CLM-413865 → UHC-04768-23 (Omar Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002878 | Orphan claim re-pointed Claims processor | CLM-418010 → UHC-91781-59 (Carol Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002879 | Orphan claim re-pointed Claims processor | CLM-420224 → UHC-68548-08 (Diego Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002880 | Orphan claim re-pointed Claims processor | CLM-417497 → UHC-30693-81 (Tylr Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002881 | Orphan claim re-pointed Claims processor | CLM-411769 → UHC-90090-71 (Alice Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002882 | Orphan claim re-pointed Claims processor | CLM-407344 → UHC-64300-08 (Douglas James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002883 | Orphan claim re-pointed Claims processor | CLM-425804 → UHC-42279-63 (Stephanie Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002884 | Orphan claim re-pointed Claims processor | CLM-402028 → UHC-96272-72 (Richard Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002885 | Orphan claim re-pointed Claims processor | CLM-425340 → UHC-73038-56 (Thomas Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002886 | Orphan claim re-pointed Claims processor | CLM-414496 → UHC-95172-81 (Aisha Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002887 | Orphan claim re-pointed Claims processor | CLM-427623 → UHC-32742-91 (Amber Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002888 | Orphan claim re-pointed Claims processor | CLM-409567 → UHC-96771-59 (Debra Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002889 | Orphan claim re-pointed Claims processor | CLM-415385 → UHC-01909-90 (Sara Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002890 | Orphan claim re-pointed Claims processor | CLM-401249 → UHC-58390-13 (Lisa Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002891 | Orphan claim re-pointed Claims processor | CLM-421971 → UHC-89812-55 (Jonathan Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002892 | Orphan claim re-pointed Claims processor | CLM-414452 → UHC-13952-38 (Yuki Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002893 | Orphan claim re-pointed Claims processor | CLM-430943 → UHC-64949-34 (Michelle Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002894 | Orphan claim re-pointed Claims processor | CLM-427160 → UHC-37768-97 (Susan Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002895 | Orphan claim re-pointed Claims processor | CLM-401794 → UHC-29142-83 (Grace James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002896 | Orphan claim re-pointed Claims processor | CLM-407517 → UHC-97544-20 (Lawrence Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002897 | Orphan claim re-pointed Claims processor | CLM-412349 → UHC-13186-78 (Valentina Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002898 | Orphan claim re-pointed Claims processor | CLM-412414 → UHC-54412-91 (Harold Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002899 | Orphan claim re-pointed Claims processor | CLM-432190 → UHC-18952-16 (Doris Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002900 | Orphan claim re-pointed Claims processor | CLM-421190 → UHC-89616-14 (Brian Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002901 | Orphan claim re-pointed Claims processor | CLM-426719 → UHC-58954-01 (Barbara Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002902 | Orphan claim re-pointed Claims processor | CLM-411097 → UHC-90440-20 (Roger Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002903 | Orphan claim re-pointed Claims processor | CLM-404163 → UHC-97762-04 (Emily Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002904 | Orphan claim re-pointed Claims processor | CLM-417095 → UHC-61639-29 (Ashley Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002905 | Orphan claim re-pointed Claims processor | CLM-402547 → UHC-75180-73 (Katherine Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002906 | Orphan claim re-pointed Claims processor | CLM-403195 → UHC-89275-42 (Dennis Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002907 | Orphan claim re-pointed Claims processor | CLM-405747 → UHC-27611-32 (Virginia Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002908 | Orphan claim re-pointed Claims processor | CLM-429405 → UHC-79908-24 (Edward Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002909 | Orphan claim re-pointed Claims processor | CLM-427849 → UHC-64161-60 (Sean Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002910 | Orphan claim re-pointed Claims processor | CLM-423049 → UHC-50559-22 (Alan Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002911 | Orphan claim re-pointed Claims processor | CLM-408620 → UHC-33957-43 (Kyle Vega) |
| 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.