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-002962 | Orphan claim re-pointed Claims processor | CLM-412854 → UHC-22603-96 (Aisha McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002963 | Orphan claim re-pointed Claims processor | CLM-409422 → UHC-40678-60 (Jesse Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002964 | Orphan claim re-pointed Claims processor | CLM-412159 → UHC-00900-40 (Benjamin Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002965 | Orphan claim re-pointed Claims processor | CLM-415292 → UHC-21639-91 (Kathryn Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002966 | Orphan claim re-pointed Claims processor | CLM-402890 → UHC-70840-06 (Grace Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002967 | Orphan claim re-pointed Claims processor | CLM-420792 → UHC-27291-77 (Diane Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002968 | Orphan claim re-pointed Claims processor | CLM-423030 → UHC-06344-17 (Diana Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002969 | Orphan claim re-pointed Claims processor | CLM-410615 → UHC-86536-44 (Bobby Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002970 | Orphan claim re-pointed Claims processor | CLM-426949 → UHC-06715-98 (Karen Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002971 | Orphan claim re-pointed Claims processor | CLM-429162 → UHC-10977-25 (Evelyn Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002972 | Orphan claim re-pointed Claims processor | CLM-400421 → UHC-99110-39 (Sophia Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002973 | Orphan claim re-pointed Claims processor | CLM-412542 → UHC-90874-75 (Debra Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002974 | Orphan claim re-pointed Claims processor | CLM-431032 → UHC-29407-99 (Lauren Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002975 | Orphan claim re-pointed Claims processor | CLM-403533 → UHC-45932-54 (Mateo Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002976 | Orphan claim re-pointed Claims processor | CLM-414180 → UHC-51915-20 (Dorothy Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002977 | Orphan claim re-pointed Claims processor | CLM-427759 → UHC-39408-66 (Raymond Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002978 | Orphan claim re-pointed Claims processor | CLM-415594 → UHC-51922-20 (Justin Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002979 | Orphan claim re-pointed Claims processor | CLM-402901 → UHC-24458-91 (Sarah Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002980 | Orphan claim re-pointed Claims processor | CLM-423654 → UHC-98958-75 (Jonathan Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002981 | Orphan claim re-pointed Claims processor | CLM-411382 → UHC-22701-62 (Brandon Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002982 | Orphan claim re-pointed Claims processor | CLM-409127 → UHC-97744-57 (Robert Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002983 | Orphan claim re-pointed Claims processor | CLM-430295 → UHC-73490-52 (Helen Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002984 | Orphan claim re-pointed Claims processor | CLM-428308 → UHC-63351-43 (Jerry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002985 | Orphan claim re-pointed Claims processor | CLM-429796 → UHC-88610-44 (Sandra Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002986 | Orphan claim re-pointed Claims processor | CLM-403194 → UHC-89275-42 (Dennis Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002987 | Orphan claim re-pointed Claims processor | CLM-420031 → UHC-84313-87 (Walter Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002988 | Orphan claim re-pointed Claims processor | CLM-417297 → UHC-16649-11 (Lawrence Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002989 | Orphan claim re-pointed Claims processor | CLM-402210 → UHC-99178-38 (Alexis Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002990 | Orphan claim re-pointed Claims processor | CLM-406552 → UHC-60822-04 (Martha Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002991 | Orphan claim re-pointed Claims processor | CLM-411223 → UHC-63213-46 (Donald Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002992 | Orphan claim re-pointed Claims processor | CLM-407649 → UHC-48905-18 (Austin Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002993 | Orphan claim re-pointed Claims processor | CLM-426806 → UHC-41493-30 (Jessica Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002994 | Orphan claim re-pointed Claims processor | CLM-402153 → UHC-80131-43 (Mary Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002995 | Orphan claim re-pointed Claims processor | CLM-408711 → UHC-66102-15 (Virginia Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002996 | Orphan claim re-pointed Claims processor | CLM-429981 → UHC-32999-29 (Susan Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002997 | Orphan claim re-pointed Claims processor | CLM-417611 → UHC-58714-51 (Mei Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002998 | Orphan claim re-pointed Claims processor | CLM-421681 → UHC-35330-66 (Abigail Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002999 | Orphan claim re-pointed Claims processor | CLM-421831 → UHC-14190-34 (Carl Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003000 | Orphan claim re-pointed Claims processor | CLM-422619 → UHC-50635-73 (Danielle Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003001 | Orphan claim re-pointed Claims processor | CLM-415428 → UHC-21356-89 (Cynthia Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003002 | Orphan claim re-pointed Claims processor | CLM-426075 → UHC-20813-41 (Dorothy Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003003 | Orphan claim re-pointed Claims processor | CLM-414984 → UHC-76613-51 (Judith Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003004 | Orphan claim re-pointed Claims processor | CLM-428404 → UHC-83800-79 (Julie Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003005 | Orphan claim re-pointed Claims processor | CLM-430383 → UHC-80730-37 (Karen Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003006 | Orphan claim re-pointed Claims processor | CLM-425854 → UHC-91907-85 (Jose Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003007 | Orphan claim re-pointed Claims processor | CLM-413855 → UHC-26778-24 (Sandra Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003008 | Orphan claim re-pointed Claims processor | CLM-428318 → UHC-40643-26 (Alice Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003009 | Orphan claim re-pointed Claims processor | CLM-422454 → UHC-60118-16 (Brittany Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003010 | Orphan claim re-pointed Claims processor | CLM-417534 → UHC-19407-98 (Jose Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003011 | Orphan claim re-pointed Claims processor | CLM-401630 → UHC-29560-29 (Kathleen Harrison) |
| 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.