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-003412 | Orphan claim re-pointed Claims processor | CLM-423872 → UHC-59566-95 (Lauren Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003413 | Orphan claim re-pointed Claims processor | CLM-400301 → UHC-98479-36 (Lauren Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003414 | Orphan claim re-pointed Claims processor | CLM-401703 → UHC-95931-01 (John Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003415 | Orphan claim re-pointed Claims processor | CLM-408792 → UHC-23112-90 (Angela Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003416 | Orphan claim re-pointed Claims processor | CLM-406897 → UHC-41118-16 (Laura Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003417 | Orphan claim re-pointed Claims processor | CLM-415889 → UHC-11747-32 (Natalie Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003418 | Orphan claim re-pointed Claims processor | CLM-423320 → UHC-18546-96 (Harold Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003419 | Orphan claim re-pointed Claims processor | CLM-406146 → UHC-02702-65 (Joyce Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003420 | Orphan claim re-pointed Claims processor | CLM-410890 → UHC-91757-89 (Katherine Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003421 | Orphan claim re-pointed Claims processor | CLM-423385 → UHC-36010-48 (Barbara Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003422 | Orphan claim re-pointed Claims processor | CLM-426552 → UHC-10433-05 (Mason Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003423 | Orphan claim re-pointed Claims processor | CLM-414919 → UHC-94540-99 (Jack Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003424 | Orphan claim re-pointed Claims processor | CLM-401607 → UHC-89089-78 (Abigail Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003425 | Orphan claim re-pointed Claims processor | CLM-431443 → UHC-81453-36 (Emily Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003426 | Orphan claim re-pointed Claims processor | CLM-420779 → UHC-15397-39 (Benjamin Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003427 | Orphan claim re-pointed Claims processor | CLM-416952 → UHC-63367-57 (Elijah Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003428 | Orphan claim re-pointed Claims processor | CLM-430531 → UHC-43689-66 (Christian Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003429 | Orphan claim re-pointed Claims processor | CLM-409958 → UHC-49773-32 (Alice Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003430 | Orphan claim re-pointed Claims processor | CLM-431920 → UHC-71352-96 (Bryan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003431 | Orphan claim re-pointed Claims processor | CLM-424575 → UHC-95551-94 (Ann White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003432 | Orphan claim re-pointed Claims processor | CLM-421928 → UHC-08853-29 (Nancy Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003433 | Orphan claim re-pointed Claims processor | CLM-413457 → UHC-91524-18 (Barbara Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003434 | Orphan claim re-pointed Claims processor | CLM-405173 → UHC-55685-78 (Barbara Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003435 | Orphan claim re-pointed Claims processor | CLM-406587 → UHC-60170-41 (Kelly Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003436 | Orphan claim re-pointed Claims processor | CLM-405612 → UHC-44784-71 (Mariana Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003437 | Orphan claim re-pointed Claims processor | CLM-425062 → UHC-06290-50 (Kyle Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003438 | Orphan claim re-pointed Claims processor | CLM-430695 → UHC-46816-90 (Linda Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003439 | Orphan claim re-pointed Claims processor | CLM-409379 → UHC-29035-01 (Cynthia Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003440 | Orphan claim re-pointed Claims processor | CLM-431065 → UHC-26396-77 (Madison Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003441 | Orphan claim re-pointed Claims processor | CLM-409008 → UHC-10689-03 (Jacqueline Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003442 | Orphan claim re-pointed Claims processor | CLM-431135 → UHC-57979-50 (Ahmed Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003443 | Orphan claim re-pointed Claims processor | CLM-410290 → UHC-03154-63 (Karen Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003444 | Orphan claim re-pointed Claims processor | CLM-419619 → UHC-01304-13 (Virginia Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003445 | Orphan claim re-pointed Claims processor | CLM-406860 → UHC-26327-53 (Green Luis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003446 | Orphan claim re-pointed Claims processor | CLM-426614 → UHC-01963-18 (Elizabeth Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003447 | Orphan claim re-pointed Claims processor | CLM-402490 → UHC-98911-16 (Sandra Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003448 | Orphan claim re-pointed Claims processor | CLM-400263 → UHC-60296-67 (Madison Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003449 | Orphan claim re-pointed Claims processor | CLM-429477 → UHC-23318-25 (Natalie Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003450 | Orphan claim re-pointed Claims processor | CLM-406025 → UHC-75871-12 (Jesse Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003451 | Orphan claim re-pointed Claims processor | CLM-403542 → UHC-74968-93 (Carol Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003452 | Orphan claim re-pointed Claims processor | CLM-428067 → UHC-16244-46 (Jason Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003453 | Orphan claim re-pointed Claims processor | CLM-409985 → UHC-32190-08 (Danielle Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003454 | Orphan claim re-pointed Claims processor | CLM-400689 → UHC-15237-29 (Pamela Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003455 | Orphan claim re-pointed Claims processor | CLM-408606 → UHC-26295-65 (Jonathan Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003456 | Orphan claim re-pointed Claims processor | CLM-428486 → UHC-96369-89 (Terry Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003457 | Orphan claim re-pointed Claims processor | CLM-422174 → UHC-31199-52 (Sarah Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003458 | Orphan claim re-pointed Claims processor | CLM-426897 → UHC-90352-64 (Stephen Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003459 | Orphan claim re-pointed Claims processor | CLM-426371 → UHC-96232-44 (Heather Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003460 | Orphan claim re-pointed Claims processor | CLM-422124 → UHC-31111-49 (Sara Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003461 | Orphan claim re-pointed Claims processor | CLM-414810 → UHC-42231-04 (Kathryn Hall) |
| 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.