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-003062 | Orphan claim re-pointed Claims processor | CLM-412321 → UHC-99279-22 (Terry Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003063 | Orphan claim re-pointed Claims processor | CLM-421416 → UHC-56962-17 (Rebecca Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003064 | Orphan claim re-pointed Claims processor | CLM-406028 → UHC-17618-84 (Douglas Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003065 | Orphan claim re-pointed Claims processor | CLM-427451 → UHC-34576-96 (Kathryn Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003066 | Orphan claim re-pointed Claims processor | CLM-400782 → UHC-70675-02 (Fatima Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003067 | Orphan claim re-pointed Claims processor | CLM-416592 → UHC-34893-97 (Sharon Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003068 | Orphan claim re-pointed Claims processor | CLM-405283 → UHC-05707-46 (Laura Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003069 | Orphan claim re-pointed Claims processor | CLM-412593 → UHC-68353-50 (Jordan Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003070 | Orphan claim re-pointed Claims processor | CLM-412323 → UHC-42796-35 (Charlotte Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003071 | Orphan claim re-pointed Claims processor | CLM-409409 → UHC-75227-24 (Larry Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003072 | Orphan claim re-pointed Claims processor | CLM-416311 → UHC-08695-23 (Walter Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003073 | Orphan claim re-pointed Claims processor | CLM-424433 → UHC-32298-88 (Samuel Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003074 | Orphan claim re-pointed Claims processor | CLM-418084 → UHC-36547-91 (Noah Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003075 | Orphan claim re-pointed Claims processor | CLM-432007 → UHC-71365-75 (Diane Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003076 | Orphan claim re-pointed Claims processor | CLM-401855 → UHC-58248-42 (Edward Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003077 | Orphan claim re-pointed Claims processor | CLM-411022 → UHC-28637-03 (Gloria Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003078 | Orphan claim re-pointed Claims processor | CLM-429862 → UHC-72812-48 (Sara Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003079 | Orphan claim re-pointed Claims processor | CLM-432343 → UHC-73398-16 (Ethan Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003080 | Orphan claim re-pointed Claims processor | CLM-415370 → UHC-39357-75 (Michelle Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003081 | Orphan claim re-pointed Claims processor | CLM-410276 → UHC-81219-28 (Martha Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003082 | Orphan claim re-pointed Claims processor | CLM-411492 → UHC-44996-73 (Gerald Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003083 | Orphan claim re-pointed Claims processor | CLM-401756 → UHC-09575-01 (Juan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003084 | Orphan claim re-pointed Claims processor | CLM-424290 → UHC-85609-56 (Martha Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003085 | Orphan claim re-pointed Claims processor | CLM-406222 → UHC-81705-08 (Bowman Emma) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003086 | Orphan claim re-pointed Claims processor | CLM-417026 → UHC-33520-63 (Gerald Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003087 | Orphan claim re-pointed Claims processor | CLM-407861 → UHC-87899-87 (Marilyn Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003088 | Orphan claim re-pointed Claims processor | CLM-408042 → UHC-75070-81 (Heather Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003089 | Orphan claim re-pointed Claims processor | CLM-413922 → UHC-31143-91 (Martha Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003090 | Orphan claim re-pointed Claims processor | CLM-412124 → UHC-50032-35 (Jeffrey Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003091 | Orphan claim re-pointed Claims processor | CLM-432335 → UHC-44242-21 (Jonathan Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003092 | Orphan claim re-pointed Claims processor | CLM-404350 → UHC-59287-85 (Kathleen Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003093 | Orphan claim re-pointed Claims processor | CLM-415845 → UHC-87921-34 (Kayla Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003094 | Orphan claim re-pointed Claims processor | CLM-404666 → UHC-43191-80 (Ronald Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003095 | Orphan claim re-pointed Claims processor | CLM-421106 → UHC-16349-63 (Stephen Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003096 | Orphan claim re-pointed Claims processor | CLM-426258 → UHC-02090-65 (Ashley Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003097 | Orphan claim re-pointed Claims processor | CLM-401485 → UHC-12051-83 (Natalie Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003098 | Orphan claim re-pointed Claims processor | CLM-422639 → UHC-31727-18 (Patricia Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003099 | Orphan claim re-pointed Claims processor | CLM-405636 → UHC-55662-93 (Brandon Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003100 | Orphan claim re-pointed Claims processor | CLM-404170 → UHC-14913-65 (Jean Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003101 | Orphan claim re-pointed Claims processor | CLM-417089 → UHC-50030-98 (Omar Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003102 | Orphan claim re-pointed Claims processor | CLM-418820 → UHC-31011-55 (Marylyn Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003103 | Orphan claim re-pointed Claims processor | CLM-428908 → UHC-67004-45 (Janice Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003104 | Orphan claim re-pointed Claims processor | CLM-422651 → UHC-54332-08 (Jaanice Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003105 | Orphan claim re-pointed Claims processor | CLM-421187 → UHC-14515-15 (Brittany Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003106 | Orphan claim re-pointed Claims processor | CLM-401062 → UHC-71981-48 (Gerald Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003107 | Orphan claim re-pointed Claims processor | CLM-410346 → UHC-39961-23 (Kevin Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003108 | Orphan claim re-pointed Claims processor | CLM-401241 → UHC-36896-26 (Linda Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003109 | Orphan claim re-pointed Claims processor | CLM-431580 → UHC-60998-16 (Richard Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003110 | Orphan claim re-pointed Claims processor | CLM-402783 → UHC-58954-87 (Wei Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003111 | Orphan claim re-pointed Claims processor | CLM-401655 → UHC-68627-66 (Albert Salazar) |
| 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.