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-003362 | Orphan claim re-pointed Claims processor | CLM-423740 → UHC-32392-13 (Pmaela Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003363 | Orphan claim re-pointed Claims processor | CLM-411190 → UHC-33676-78 (Brandon Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003364 | Orphan claim re-pointed Claims processor | CLM-412734 → UHC-44774-84 (Eugene Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003365 | Orphan claim re-pointed Claims processor | CLM-407552 → UHC-56755-08 (Samantha Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003366 | Orphan claim re-pointed Claims processor | CLM-402602 → UHC-45508-66 (Thomas Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003367 | Orphan claim re-pointed Claims processor | CLM-422628 → UHC-25483-47 (Diane Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003368 | Orphan claim re-pointed Claims processor | CLM-416621 → UHC-22905-01 (Wayne Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003369 | Orphan claim re-pointed Claims processor | CLM-409971 → UHC-84539-43 (Dylan Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003370 | Orphan claim re-pointed Claims processor | CLM-425866 → UHC-28110-84 (Roger Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003371 | Orphan claim re-pointed Claims processor | CLM-425605 → UHC-75343-29 (Lauren Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003372 | Orphan claim re-pointed Claims processor | CLM-404383 → UHC-06599-74 (Arthur Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003373 | Orphan claim re-pointed Claims processor | CLM-404559 → UHC-45682-55 (David Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003374 | Orphan claim re-pointed Claims processor | CLM-409901 → UHC-39979-07 (Scott Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003375 | Orphan claim re-pointed Claims processor | CLM-403359 → UHC-56158-59 (Jose Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003376 | Orphan claim re-pointed Claims processor | CLM-413689 → UHC-35596-29 (Anthony Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003377 | Orphan claim re-pointed Claims processor | CLM-403323 → UHC-76050-53 (Luis Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003378 | Orphan claim re-pointed Claims processor | CLM-402259 → UHC-45753-10 (Andrea Gonzles) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003379 | Orphan claim re-pointed Claims processor | CLM-428042 → UHC-34443-43 (Austin Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003380 | Orphan claim re-pointed Claims processor | CLM-431039 → UHC-04560-91 (Madison Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003381 | Orphan claim re-pointed Claims processor | CLM-417186 → UHC-87854-09 (Julia Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003382 | Orphan claim re-pointed Claims processor | CLM-430816 → UHC-56570-23 (Diego Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003383 | Orphan claim re-pointed Claims processor | CLM-425254 → UHC-36645-75 (Sophia Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003384 | Orphan claim re-pointed Claims processor | CLM-407307 → UHC-77213-11 (Rachel Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003385 | Orphan claim re-pointed Claims processor | CLM-418220 → UHC-37752-51 (Stephen Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003386 | Orphan claim re-pointed Claims processor | CLM-426778 → UHC-97344-04 (Roy Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003387 | Orphan claim re-pointed Claims processor | CLM-412063 → UHC-76772-44 (Bradley Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003388 | Orphan claim re-pointed Claims processor | CLM-426520 → UHC-76289-79 (Kelly Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003389 | Orphan claim re-pointed Claims processor | CLM-406267 → UHC-11986-50 (Justin Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003390 | Orphan claim re-pointed Claims processor | CLM-406450 → UHC-21684-62 (Sophia Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003391 | Orphan claim re-pointed Claims processor | CLM-402371 → UHC-45752-49 (Debra Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003392 | Orphan claim re-pointed Claims processor | CLM-400897 → UHC-83341-11 (Olivia Olivia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003393 | Orphan claim re-pointed Claims processor | CLM-423904 → UHC-75138-92 (Camila Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003394 | Orphan claim re-pointed Claims processor | CLM-409965 → UHC-08632-94 (Henry Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003395 | Orphan claim re-pointed Claims processor | CLM-415848 → UHC-89742-06 (Camila Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003396 | Orphan claim re-pointed Claims processor | CLM-406942 → UHC-39071-71 (Natalie Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003397 | Orphan claim re-pointed Claims processor | CLM-421936 → UHC-62961-20 (Wei Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003398 | Orphan claim re-pointed Claims processor | CLM-407791 → UHC-46045-09 (Jonathan Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003399 | Orphan claim re-pointed Claims processor | CLM-423728 → UHC-28983-41 (Grace Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003400 | Orphan claim re-pointed Claims processor | CLM-403718 → UHC-33098-14 (Matthew Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003401 | Orphan claim re-pointed Claims processor | CLM-400385 → UHC-25857-44 (Alice Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003402 | Orphan claim re-pointed Claims processor | CLM-426488 → UHC-22092-71 (Seen Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003403 | Orphan claim re-pointed Claims processor | CLM-432412 → UHC-61460-03 (Judy Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003404 | Orphan claim re-pointed Claims processor | CLM-416981 → UHC-19530-96 (Sarah Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003405 | Orphan claim re-pointed Claims processor | CLM-406260 → UHC-01980-86 (Sophia Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003406 | Orphan claim re-pointed Claims processor | CLM-405352 → UHC-96725-82 (Santiago Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003407 | Orphan claim re-pointed Claims processor | CLM-417965 → UHC-92206-23 (Sofia Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003408 | Orphan claim re-pointed Claims processor | CLM-403296 → UHC-48999-54 (Billy Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003409 | Orphan claim re-pointed Claims processor | CLM-419309 → UHC-92686-75 (Rebecca Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003410 | Orphan claim re-pointed Claims processor | CLM-412448 → UHC-47662-48 (Kevin Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003411 | Orphan claim re-pointed Claims processor | CLM-401110 → UHC-76166-29 (Timothy Hernandez) |
| 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.