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-003162 | Orphan claim re-pointed Claims processor | CLM-405741 → UHC-43823-71 (Bobby Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003163 | Orphan claim re-pointed Claims processor | CLM-411919 → UHC-29398-05 (Julia Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003164 | Orphan claim re-pointed Claims processor | CLM-410529 → UHC-98736-97 (Bradley Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003165 | Orphan claim re-pointed Claims processor | CLM-428165 → UHC-53344-87 (Dylan King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003166 | Orphan claim re-pointed Claims processor | CLM-409038 → UHC-44473-39 (Allbert Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003167 | Orphan claim re-pointed Claims processor | CLM-409547 → UHC-71447-86 (Stephanie Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003168 | Orphan claim re-pointed Claims processor | CLM-431532 → UHC-64427-62 (Zachary Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003169 | Orphan claim re-pointed Claims processor | CLM-405451 → UHC-99272-28 (Jacob McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003170 | Orphan claim re-pointed Claims processor | CLM-430363 → UHC-76562-94 (Janet Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003171 | Orphan claim re-pointed Claims processor | CLM-427582 → UHC-53260-05 (Ralph Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003172 | Orphan claim re-pointed Claims processor | CLM-429705 → UHC-09752-86 (Joshua Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003173 | Orphan claim re-pointed Claims processor | CLM-414906 → UHC-54824-57 (Joe Edwardds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003174 | Orphan claim re-pointed Claims processor | CLM-422247 → UHC-48942-70 (Janice Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003175 | Orphan claim re-pointed Claims processor | CLM-419942 → UHC-60747-77 (Robert Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003176 | Orphan claim re-pointed Claims processor | CLM-401881 → UHC-51254-08 (Patricia Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003177 | Orphan claim re-pointed Claims processor | CLM-428146 → UHC-37090-48 (Mei Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003178 | Orphan claim re-pointed Claims processor | CLM-414795 → UHC-80952-81 (Pamela Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003179 | Orphan claim re-pointed Claims processor | CLM-419260 → UHC-44427-94 (Stephen Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003180 | Orphan claim re-pointed Claims processor | CLM-418919 → UHC-08048-85 (Melissa Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003181 | Orphan claim re-pointed Claims processor | CLM-421620 → UHC-86083-05 (Teresa Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003182 | Orphan claim re-pointed Claims processor | CLM-418873 → UHC-44238-24 (Joseph Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003183 | Orphan claim re-pointed Claims processor | CLM-408331 → UHC-50574-71 (Rebecca Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003184 | Orphan claim re-pointed Claims processor | CLM-402723 → UHC-35765-08 (Gerald Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003185 | Orphan claim re-pointed Claims processor | CLM-403970 → UHC-48286-43 (Kenneth Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003186 | Orphan claim re-pointed Claims processor | CLM-406890 → UHC-96152-36 (Priya Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003187 | Orphan claim re-pointed Claims processor | CLM-412126 → UHC-98227-66 (Fatima Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003188 | Orphan claim re-pointed Claims processor | CLM-429234 → UHC-11118-67 (Natalie Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003189 | Orphan claim re-pointed Claims processor | CLM-408969 → UHC-27109-52 (Megan Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003190 | Orphan claim re-pointed Claims processor | CLM-413415 → UHC-03506-53 (Bobby Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003191 | Orphan claim re-pointed Claims processor | CLM-404189 → UHC-96450-94 (Ryan Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003192 | Orphan claim re-pointed Claims processor | CLM-406092 → UHC-24038-47 (Kayla Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003193 | Orphan claim re-pointed Claims processor | CLM-427272 → UHC-46810-51 (Andrea Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003194 | Orphan claim re-pointed Claims processor | CLM-401027 → UHC-89960-59 (Maria Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003195 | Orphan claim re-pointed Claims processor | CLM-406042 → UHC-91522-50 (Barbara Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003196 | Orphan claim re-pointed Claims processor | CLM-425891 → UHC-90277-38 (Randy Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003197 | Orphan claim re-pointed Claims processor | CLM-425066 → UHC-92098-20 (Danielle Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003198 | Orphan claim re-pointed Claims processor | CLM-425491 → UHC-29134-81 (Kathleen Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003199 | Orphan claim re-pointed Claims processor | CLM-423192 → UHC-11466-95 (Nicholas Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003200 | Orphan claim re-pointed Claims processor | CLM-412376 → UHC-44193-52 (Mei Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003201 | Orphan claim re-pointed Claims processor | CLM-415255 → UHC-16904-99 (Ralph Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003202 | Orphan claim re-pointed Claims processor | CLM-429176 → UHC-68765-49 (Virginia Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003203 | Orphan claim re-pointed Claims processor | CLM-431250 → UHC-93560-89 (Barbara Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003204 | Orphan claim re-pointed Claims processor | CLM-412960 → UHC-14875-55 (Scott Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003205 | Orphan claim re-pointed Claims processor | CLM-430934 → UHC-56499-04 (Deborah Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003206 | Orphan claim re-pointed Claims processor | CLM-428161 → UHC-30097-39 (Shirley Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003207 | Orphan claim re-pointed Claims processor | CLM-401862 → UHC-27010-24 (Emily Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003208 | Orphan claim re-pointed Claims processor | CLM-422638 → UHC-31727-18 (Patricia Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003209 | Orphan claim re-pointed Claims processor | CLM-428381 → UHC-18632-72 (Juan Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003210 | Orphan claim re-pointed Claims processor | CLM-411119 → UHC-87523-88 (Jessica Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003211 | Orphan claim re-pointed Claims processor | CLM-414796 → UHC-99785-70 (Julia Weber) |
| 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.