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-003262 | Orphan claim re-pointed Claims processor | CLM-422265 → UHC-72889-66 (Mark Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003263 | Orphan claim re-pointed Claims processor | CLM-423867 → UHC-20959-12 (Ronald Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003264 | Orphan claim re-pointed Claims processor | CLM-424591 → UHC-63153-81 (Paul Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003265 | Orphan claim re-pointed Claims processor | CLM-420729 → UHC-57748-11 (Ronald Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003266 | Orphan claim re-pointed Claims processor | CLM-406948 → UHC-83147-93 (Vincent Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003267 | Orphan claim re-pointed Claims processor | CLM-407341 → UHC-97852-59 (Carolyn Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003268 | Orphan claim re-pointed Claims processor | CLM-426129 → UHC-18976-70 (James Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003269 | Orphan claim re-pointed Claims processor | CLM-428413 → UHC-47454-98 (William Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003270 | Orphan claim re-pointed Claims processor | CLM-426473 → UHC-96293-49 (Deborah Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003271 | Orphan claim re-pointed Claims processor | CLM-412273 → UHC-76708-28 (Thomas Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003272 | Orphan claim re-pointed Claims processor | CLM-400577 → UHC-32829-25 (Ronald Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003273 | Orphan claim re-pointed Claims processor | CLM-432502 → UHC-88692-40 (Lori Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003274 | Orphan claim re-pointed Claims processor | CLM-409426 → UHC-11986-61 (Brandon Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003275 | Orphan claim re-pointed Claims processor | CLM-425038 → UHC-64570-80 (Kathryn Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003276 | Orphan claim re-pointed Claims processor | CLM-414905 → UHC-00467-13 (Alert James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003277 | Orphan claim re-pointed Claims processor | CLM-404371 → UHC-68806-30 (Anthony Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003278 | Orphan claim re-pointed Claims processor | CLM-418795 → UHC-51875-33 (Donald Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003279 | Orphan claim re-pointed Claims processor | CLM-403138 → UHC-98539-12 (Mei Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003280 | Orphan claim re-pointed Claims processor | CLM-432596 → UHC-45306-29 (Emily Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003281 | Orphan claim re-pointed Claims processor | CLM-410148 → UHC-40867-57 (Alexis Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003282 | Orphan claim re-pointed Claims processor | CLM-404942 → UHC-05073-10 (Russell Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003283 | Orphan claim re-pointed Claims processor | CLM-406375 → UHC-84795-06 (Ajun Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003284 | Orphan claim re-pointed Claims processor | CLM-430457 → UHC-50436-75 (Benjamin Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003285 | Orphan claim re-pointed Claims processor | CLM-424210 → UHC-04826-75 (Anna Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003286 | Orphan claim re-pointed Claims processor | CLM-430540 → UHC-13421-40 (Sandra White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003287 | Orphan claim re-pointed Claims processor | CLM-429479 → UHC-16406-79 (Denise Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003288 | Orphan claim re-pointed Claims processor | CLM-410664 → UHC-08940-62 (Carolyn King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003289 | Orphan claim re-pointed Claims processor | CLM-407616 → UHC-91769-61 (Barbara Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003290 | Orphan claim re-pointed Claims processor | CLM-404674 → UHC-87798-97 (Sophia Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003291 | Orphan claim re-pointed Claims processor | CLM-401570 → UHC-28829-66 (David Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003292 | Orphan claim re-pointed Claims processor | CLM-424731 → UHC-00426-62 (Philip Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003293 | Orphan claim re-pointed Claims processor | CLM-401225 → UHC-75662-02 (Ann Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003294 | Orphan claim re-pointed Claims processor | CLM-403730 → UHC-02004-26 (Jessica Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003295 | Orphan claim re-pointed Claims processor | CLM-427057 → UHC-13302-16 (Jason Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003296 | Orphan claim re-pointed Claims processor | CLM-418977 → UHC-62532-33 (Sarah Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003297 | Orphan claim re-pointed Claims processor | CLM-424308 → UHC-11160-33 (Wei Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003298 | Orphan claim re-pointed Claims processor | CLM-417648 → UHC-20851-36 (Olivia Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003299 | Orphan claim re-pointed Claims processor | CLM-426370 → UHC-69885-08 (Mei Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003300 | Orphan claim re-pointed Claims processor | CLM-415060 → UHC-00530-80 (Diana Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003301 | Orphan claim re-pointed Claims processor | CLM-409577 → UHC-89088-77 (Guzman Kathryn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003302 | Orphan claim re-pointed Claims processor | CLM-405131 → UHC-93283-17 (Carl Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003303 | Orphan claim re-pointed Claims processor | CLM-403602 → UHC-73331-86 (Mary Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003304 | Orphan claim re-pointed Claims processor | CLM-408637 → UHC-25366-78 (Jonathan Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003305 | Orphan claim re-pointed Claims processor | CLM-420527 → UHC-53502-65 (George Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003306 | Orphan claim re-pointed Claims processor | CLM-424163 → UHC-81991-36 (Gary Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003307 | Orphan claim re-pointed Claims processor | CLM-409400 → UHC-69356-13 (Arjun Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003308 | Orphan claim re-pointed Claims processor | CLM-413465 → UHC-35456-26 (Isabella Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003309 | Orphan claim re-pointed Claims processor | CLM-425351 → UHC-78785-52 (Carl Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003310 | Orphan claim re-pointed Claims processor | CLM-410953 → UHC-08945-48 (Alexander Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003311 | Orphan claim re-pointed Claims processor | CLM-402546 → UHC-93710-38 (Jennifer Baker) |
| 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.