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-003212 | Orphan claim re-pointed Claims processor | CLM-418616 → UHC-03397-06 (Natalie Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003213 | Orphan claim re-pointed Claims processor | CLM-408713 → UHC-60268-18 (Carlos Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003214 | Orphan claim re-pointed Claims processor | CLM-421945 → UHC-13221-79 (Harold Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003215 | Orphan claim re-pointed Claims processor | CLM-419019 → UHC-10886-62 (Josua Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003216 | Orphan claim re-pointed Claims processor | CLM-428945 → UHC-97391-25 (Pamela Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003217 | Orphan claim re-pointed Claims processor | CLM-423650 → UHC-56594-06 (Mason Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003218 | Orphan claim re-pointed Claims processor | CLM-432506 → UHC-50103-28 (Laura Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003219 | Orphan claim re-pointed Claims processor | CLM-414153 → UHC-21155-12 (Benjamin Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003220 | Orphan claim re-pointed Claims processor | CLM-416086 → UHC-71965-17 (Arjun Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003221 | Orphan claim re-pointed Claims processor | CLM-412495 → UHC-69888-49 (Cynthia Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003222 | Orphan claim re-pointed Claims processor | CLM-421441 → UHC-72044-34 (Victoria Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003223 | Orphan claim re-pointed Claims processor | CLM-415244 → UHC-34996-49 (Ann Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003224 | Orphan claim re-pointed Claims processor | CLM-418350 → UHC-16280-18 (Stephen Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003225 | Orphan claim re-pointed Claims processor | CLM-413267 → UHC-97917-42 (Katherine Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003226 | Orphan claim re-pointed Claims processor | CLM-430148 → UHC-37114-42 (Mariana Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003227 | Orphan claim re-pointed Claims processor | CLM-412596 → UHC-43169-47 (Kathleen Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003228 | Orphan claim re-pointed Claims processor | CLM-427545 → UHC-33142-39 (Joe Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003229 | Orphan claim re-pointed Claims processor | CLM-418594 → UHC-97802-47 (Jessica Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003230 | Orphan claim re-pointed Claims processor | CLM-430950 → UHC-06199-48 (Timothy Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003231 | Orphan claim re-pointed Claims processor | CLM-408301 → UHC-60955-24 (Michelle Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003232 | Orphan claim re-pointed Claims processor | CLM-408128 → UHC-76335-04 (Christian Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003233 | Orphan claim re-pointed Claims processor | CLM-401040 → UHC-21428-38 (Denise Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003234 | Orphan claim re-pointed Claims processor | CLM-432517 → UHC-44059-85 (Isabella Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003235 | Orphan claim re-pointed Claims processor | CLM-408849 → UHC-25369-28 (Mariana Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003236 | Orphan claim re-pointed Claims processor | CLM-427292 → UHC-01570-93 (Theresa King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003237 | Orphan claim re-pointed Claims processor | CLM-426753 → UHC-85125-76 (Raymond Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003238 | Orphan claim re-pointed Claims processor | CLM-426185 → UHC-68036-12 (Alexander Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003239 | Orphan claim re-pointed Claims processor | CLM-410304 → UHC-58060-51 (Emma Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003240 | Orphan claim re-pointed Claims processor | CLM-422442 → UHC-22819-36 (Emma Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003241 | Orphan claim re-pointed Claims processor | CLM-418490 → UHC-39290-06 (Linda Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003242 | Orphan claim re-pointed Claims processor | CLM-427235 → UHC-12535-13 (Joseph Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003243 | Orphan claim re-pointed Claims processor | CLM-418773 → UHC-04889-09 (Alice Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003244 | Orphan claim re-pointed Claims processor | CLM-406871 → UHC-12751-91 (Aaron Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003245 | Orphan claim re-pointed Claims processor | CLM-421288 → UHC-37929-30 (Lawrence Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003246 | Orphan claim re-pointed Claims processor | CLM-415873 → UHC-14307-75 (Judy Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003247 | Orphan claim re-pointed Claims processor | CLM-421785 → UHC-71838-89 (Roger Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003248 | Orphan claim re-pointed Claims processor | CLM-422258 → UHC-69469-95 (Albert Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003249 | Orphan claim re-pointed Claims processor | CLM-402688 → UHC-16878-36 (Noah Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003250 | Orphan claim re-pointed Claims processor | CLM-404121 → UHC-51711-74 (Lisa Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003251 | Orphan claim re-pointed Claims processor | CLM-407684 → UHC-79068-41 (Mark Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003252 | Orphan claim re-pointed Claims processor | CLM-404077 → UHC-69805-53 (Sandra Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003253 | Orphan claim re-pointed Claims processor | CLM-423636 → UHC-18220-29 (Olivia Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003254 | Orphan claim re-pointed Claims processor | CLM-403252 → UHC-76538-79 (Terry Rodriugez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003255 | Orphan claim re-pointed Claims processor | CLM-424934 → UHC-38887-29 (Jeffrey Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003256 | Orphan claim re-pointed Claims processor | CLM-427215 → UHC-55178-78 (Ashley Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003257 | Orphan claim re-pointed Claims processor | CLM-412882 → UHC-01923-32 (James Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003258 | Orphan claim re-pointed Claims processor | CLM-408029 → UHC-52299-91 (Virginia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003259 | Orphan claim re-pointed Claims processor | CLM-411996 → UHC-87060-63 (Briaan Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003260 | Orphan claim re-pointed Claims processor | CLM-426915 → UHC-92801-47 (Susan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003261 | Orphan claim re-pointed Claims processor | CLM-424396 → UHC-52523-92 (Randy Porter) |
| 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.