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-002912 | Orphan claim re-pointed Claims processor | CLM-427924 → UHC-21648-41 (Marcus Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002913 | Orphan claim re-pointed Claims processor | CLM-429845 → UHC-24431-19 (Diane Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002914 | Orphan claim re-pointed Claims processor | CLM-418916 → UHC-04083-81 (Natalie Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002915 | Orphan claim re-pointed Claims processor | CLM-402012 → UHC-30565-43 (Natalie Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002916 | Orphan claim re-pointed Claims processor | CLM-413846 → UHC-02340-97 (Mei Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002917 | Orphan claim re-pointed Claims processor | CLM-400943 → UHC-76429-95 (Amber Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002918 | Orphan claim re-pointed Claims processor | CLM-412343 → UHC-19218-47 (Katherine Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002919 | Orphan claim re-pointed Claims processor | CLM-413593 → UHC-13835-02 (Mark Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002920 | Orphan claim re-pointed Claims processor | CLM-422019 → UHC-66524-42 (Cynthia Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002921 | Orphan claim re-pointed Claims processor | CLM-425923 → UHC-94421-04 (Megan Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002922 | Orphan claim re-pointed Claims processor | CLM-421606 → UHC-29310-40 (Joe Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002923 | Orphan claim re-pointed Claims processor | CLM-401100 → UHC-51567-53 (Martha Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002924 | Orphan claim re-pointed Claims processor | CLM-417977 → UHC-48459-62 (Hiroshi Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002925 | Orphan claim re-pointed Claims processor | CLM-426577 → UHC-28952-82 (Ralph Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002926 | Orphan claim re-pointed Claims processor | CLM-421547 → UHC-89061-19 (Nathan Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002927 | Orphan claim re-pointed Claims processor | CLM-416144 → UHC-00245-28 (Bryan Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002928 | Orphan claim re-pointed Claims processor | CLM-405290 → UHC-97566-56 (Catherine Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002929 | Orphan claim re-pointed Claims processor | CLM-416559 → UHC-69037-54 (Jack Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002930 | Orphan claim re-pointed Claims processor | CLM-428512 → UHC-54516-18 (Hannah Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002931 | Orphan claim re-pointed Claims processor | CLM-406666 → UHC-90741-18 (Randy Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002932 | Orphan claim re-pointed Claims processor | CLM-407292 → UHC-65197-96 (Joyce Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002933 | Orphan claim re-pointed Claims processor | CLM-427424 → UHC-83773-63 (Eric Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002934 | Orphan claim re-pointed Claims processor | CLM-421119 → UHC-85610-69 (Evelyn Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002935 | Orphan claim re-pointed Claims processor | CLM-419744 → UHC-31513-50 (Sophia Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002936 | Orphan claim re-pointed Claims processor | CLM-419553 → UHC-28348-73 (Gerald Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002937 | Orphan claim re-pointed Claims processor | CLM-423377 → UHC-34873-65 (Jacob Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002938 | Orphan claim re-pointed Claims processor | CLM-432355 → UHC-34803-46 (Mariana Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002939 | Orphan claim re-pointed Claims processor | CLM-417437 → UHC-92117-15 (Angela Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002940 | Orphan claim re-pointed Claims processor | CLM-411495 → UHC-15071-61 (Edward Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002941 | Orphan claim re-pointed Claims processor | CLM-427748 → UHC-55520-85 (Mark Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002942 | Orphan claim re-pointed Claims processor | CLM-417547 → UHC-94639-58 (Cynthia Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002943 | Orphan claim re-pointed Claims processor | CLM-417433 → UHC-20657-68 (Vicky Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002944 | Orphan claim re-pointed Claims processor | CLM-406210 → UHC-00624-02 (Kathryn Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002945 | Orphan claim re-pointed Claims processor | CLM-407950 → UHC-49719-35 (Juan Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002946 | Orphan claim re-pointed Claims processor | CLM-407389 → UHC-64364-04 (Barb Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002947 | Orphan claim re-pointed Claims processor | CLM-410179 → UHC-54232-44 (Brian Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002948 | Orphan claim re-pointed Claims processor | CLM-411071 → UHC-35219-28 (Elizabeth Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002949 | Orphan claim re-pointed Claims processor | CLM-400832 → UHC-00120-23 (Hannah Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002950 | Orphan claim re-pointed Claims processor | CLM-426232 → UHC-68851-64 (Russell Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002951 | Orphan claim re-pointed Claims processor | CLM-425972 → UHC-96613-08 (Natalie Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002952 | Orphan claim re-pointed Claims processor | CLM-407714 → UHC-43246-58 (Amy Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002953 | Orphan claim re-pointed Claims processor | CLM-416652 → UHC-53251-10 (Lori Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002954 | Orphan claim re-pointed Claims processor | CLM-423809 → UHC-94219-79 (Natalie Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002955 | Orphan claim re-pointed Claims processor | CLM-429302 → UHC-72399-15 (Kimberly Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002956 | Orphan claim re-pointed Claims processor | CLM-408653 → UHC-87938-64 (Katherine Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002957 | Orphan claim re-pointed Claims processor | CLM-402947 → UHC-97085-20 (Chistine Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002958 | Orphan claim re-pointed Claims processor | CLM-431015 → UHC-49258-37 (Chritsian Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002959 | Orphan claim re-pointed Claims processor | CLM-423800 → UHC-40176-31 (Isabella Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002960 | Orphan claim re-pointed Claims processor | CLM-401290 → UHC-91005-74 (Nancy George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002961 | Orphan claim re-pointed Claims processor | CLM-404991 → UHC-58921-61 (Samuel Cruz) |
| 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.