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-003312 | Orphan claim re-pointed Claims processor | CLM-426527 → UHC-96480-12 (Stephanie Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003313 | Orphan claim re-pointed Claims processor | CLM-432546 → UHC-65896-08 (Jdy Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003314 | Orphan claim re-pointed Claims processor | CLM-413493 → UHC-86270-14 (Richard Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003315 | Orphan claim re-pointed Claims processor | CLM-427146 → UHC-29997-83 (Priya Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003316 | Orphan claim re-pointed Claims processor | CLM-417793 → UHC-64715-69 (Arjun Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003317 | Orphan claim re-pointed Claims processor | CLM-409289 → UHC-43144-61 (Benjamin Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003318 | Orphan claim re-pointed Claims processor | CLM-425111 → UHC-46808-74 (Teresa Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003319 | Orphan claim re-pointed Claims processor | CLM-405871 → UHC-12735-84 (Ralph Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003320 | Orphan claim re-pointed Claims processor | CLM-429776 → UHC-46226-50 (Daniele Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003321 | Orphan claim re-pointed Claims processor | CLM-403679 → UHC-38568-32 (Frank Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003322 | Orphan claim re-pointed Claims processor | CLM-402735 → UHC-42403-07 (Joe Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003323 | Orphan claim re-pointed Claims processor | CLM-414773 → UHC-22083-44 (Willie McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003324 | Orphan claim re-pointed Claims processor | CLM-415795 → UHC-36240-36 (Charles Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003325 | Orphan claim re-pointed Claims processor | CLM-407765 → UHC-32138-49 (Kimberly Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003326 | Orphan claim re-pointed Claims processor | CLM-408497 → UHC-19437-72 (Judy Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003327 | Orphan claim re-pointed Claims processor | CLM-425476 → UHC-10656-62 (Bobby Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003328 | Orphan claim re-pointed Claims processor | CLM-413889 → UHC-09134-29 (Deborah Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003329 | Orphan claim re-pointed Claims processor | CLM-412067 → UHC-79382-41 (Ruth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003330 | Orphan claim re-pointed Claims processor | CLM-424185 → UHC-21057-88 (Cheryl Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003331 | Orphan claim re-pointed Claims processor | CLM-424925 → UHC-97244-05 (Doris Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003332 | Orphan claim re-pointed Claims processor | CLM-415358 → UHC-19167-90 (Bobby Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003333 | Orphan claim re-pointed Claims processor | CLM-419913 → UHC-68580-40 (Cynthia Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003334 | Orphan claim re-pointed Claims processor | CLM-409617 → UHC-70330-92 (Albert Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003335 | Orphan claim re-pointed Claims processor | CLM-431176 → UHC-86368-16 (Mateo Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003336 | Orphan claim re-pointed Claims processor | CLM-410434 → UHC-98014-78 (Emma Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003337 | Orphan claim re-pointed Claims processor | CLM-403285 → UHC-52805-66 (Judith Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003338 | Orphan claim re-pointed Claims processor | CLM-410973 → UHC-29968-36 (Thomas Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003339 | Orphan claim re-pointed Claims processor | CLM-415500 → UHC-71089-33 (Sharon Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003340 | Orphan claim re-pointed Claims processor | CLM-405372 → UHC-30911-04 (Jennifer Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003341 | Orphan claim re-pointed Claims processor | CLM-403844 → UHC-50312-75 (Kimberly Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003342 | Orphan claim re-pointed Claims processor | CLM-404231 → UHC-22060-18 (Ruth McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003343 | Orphan claim re-pointed Claims processor | CLM-427303 → UHC-88625-13 (Tyler Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003344 | Orphan claim re-pointed Claims processor | CLM-418100 → UHC-05763-13 (Denise Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003345 | Orphan claim re-pointed Claims processor | CLM-407502 → UHC-86804-48 (Camila Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003346 | Orphan claim re-pointed Claims processor | CLM-427404 → UHC-55073-04 (Luis Leewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003347 | Orphan claim re-pointed Claims processor | CLM-413350 → UHC-16028-30 (Emma Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003348 | Orphan claim re-pointed Claims processor | CLM-410898 → UHC-14493-37 (Cheryl Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003349 | Orphan claim re-pointed Claims processor | CLM-403915 → UHC-34464-25 (Arthur Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003350 | Orphan claim re-pointed Claims processor | CLM-431784 → UHC-85105-06 (Michelle Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003351 | Orphan claim re-pointed Claims processor | CLM-429638 → UHC-79488-43 (Ashley Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003352 | Orphan claim re-pointed Claims processor | CLM-410209 → UHC-84878-58 (Sarah Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003353 | Orphan claim re-pointed Claims processor | CLM-401846 → UHC-21471-68 (Ana Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003354 | Orphan claim re-pointed Claims processor | CLM-410695 → UHC-77460-19 (Emily Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003355 | Orphan claim re-pointed Claims processor | CLM-431993 → UHC-42321-42 (Sarah Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003356 | Orphan claim re-pointed Claims processor | CLM-407351 → UHC-10303-10 (Nicholas Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003357 | Orphan claim re-pointed Claims processor | CLM-413984 → UHC-82124-92 (Rachel Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003358 | Orphan claim re-pointed Claims processor | CLM-425609 → UHC-84542-04 (Nicole Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003359 | Orphan claim re-pointed Claims processor | CLM-410789 → UHC-38202-11 (Deb McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003360 | Orphan claim re-pointed Claims processor | CLM-416031 → UHC-87826-91 (Melissa Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003361 | Orphan claim re-pointed Claims processor | CLM-418188 → UHC-96996-81 (Jennifer Powell) |
| 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.