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-003462 | Orphan claim re-pointed Claims processor | CLM-412243 → UHC-40023-82 (Victoria Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003463 | Orphan claim re-pointed Claims processor | CLM-403698 → UHC-23547-97 (Park Jonathan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003464 | Orphan claim re-pointed Claims processor | CLM-431450 → UHC-31781-97 (Anna Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003465 | Orphan claim re-pointed Claims processor | CLM-412057 → UHC-61845-14 (Hannah Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003466 | Orphan claim re-pointed Claims processor | CLM-410101 → UHC-71809-10 (Rebecca Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003467 | Orphan claim re-pointed Claims processor | CLM-411518 → UHC-98692-59 (Peter Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003468 | Orphan claim re-pointed Claims processor | CLM-415178 → UHC-41067-77 (Frank Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003469 | Orphan claim re-pointed Claims processor | CLM-416589 → UHC-13389-59 (Christopher Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003470 | Orphan claim re-pointed Claims processor | CLM-411932 → UHC-35659-03 (Ana Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003471 | Orphan claim re-pointed Claims processor | CLM-414457 → UHC-13241-25 (Emma McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003472 | Orphan claim re-pointed Claims processor | CLM-422725 → UHC-27129-15 (Gerald Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003473 | Orphan claim re-pointed Claims processor | CLM-421266 → UHC-86167-37 (Christian Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003474 | Orphan claim re-pointed Claims processor | CLM-427217 → UHC-66661-01 (Amanda Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003475 | Orphan claim re-pointed Claims processor | CLM-429766 → UHC-93948-39 (Kathryn Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003476 | Orphan claim re-pointed Claims processor | CLM-427168 → UHC-36711-03 (Doris Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003477 | Orphan claim re-pointed Claims processor | CLM-429246 → UHC-09503-37 (Stephanie Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003478 | Orphan claim re-pointed Claims processor | CLM-406889 → UHC-96152-36 (Priya Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003479 | Orphan claim re-pointed Claims processor | CLM-407477 → UHC-63528-39 (Sara Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003480 | Orphan claim re-pointed Claims processor | CLM-407909 → UHC-44850-78 (Michelle Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003481 | Orphan claim re-pointed Claims processor | CLM-427781 → UHC-33831-92 (Robert Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003482 | Orphan claim re-pointed Claims processor | CLM-420664 → UHC-17753-40 (Scott Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003483 | Orphan claim re-pointed Claims processor | CLM-410171 → UHC-74527-12 (Lauren Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003484 | Orphan claim re-pointed Claims processor | CLM-410270 → UHC-15131-53 (Rebecca Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003485 | Orphan claim re-pointed Claims processor | CLM-419105 → UHC-65879-07 (Gregory Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003486 | Orphan claim re-pointed Claims processor | CLM-423465 → UHC-07211-06 (Amber Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003487 | Orphan claim re-pointed Claims processor | CLM-409419 → UHC-38119-75 (Robert Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003488 | Orphan claim re-pointed Claims processor | CLM-414870 → UHC-18183-88 (Dorothy Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003489 | Orphan claim re-pointed Claims processor | CLM-416751 → UHC-71644-16 (Omar Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003490 | Orphan claim re-pointed Claims processor | CLM-431813 → UHC-08132-83 (Alexis McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003491 | Orphan claim re-pointed Claims processor | CLM-407801 → UHC-48704-64 (Eric Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003492 | Orphan claim re-pointed Claims processor | CLM-429675 → UHC-32037-03 (Rachel Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003493 | Orphan claim re-pointed Claims processor | CLM-405418 → UHC-21603-47 (Roger Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003494 | Orphan claim re-pointed Claims processor | CLM-413892 → UHC-86816-93 (Aisha Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003495 | Orphan claim re-pointed Claims processor | CLM-424453 → UHC-24245-99 (Austin Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003496 | Orphan claim re-pointed Claims processor | CLM-431036 → UHC-15465-68 (Emily Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003497 | Orphan claim re-pointed Claims processor | CLM-418750 → UHC-02927-16 (Saamuel Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003498 | Orphan claim re-pointed Claims processor | CLM-404285 → UHC-48762-31 (Helen McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003499 | Orphan claim re-pointed Claims processor | CLM-427765 → UHC-93261-88 (Anthony Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003500 | Orphan claim re-pointed Claims processor | CLM-410765 → UHC-05869-27 (Brittany Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003501 | Orphan claim re-pointed Claims processor | CLM-425817 → UHC-57021-61 (Christine Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003502 | Orphan claim re-pointed Claims processor | CLM-416519 → UHC-24158-50 (Billy Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003503 | Orphan claim re-pointed Claims processor | CLM-425139 → UHC-19058-33 (Logan Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003504 | Orphan claim re-pointed Claims processor | CLM-431581 → UHC-38179-85 (Sarah Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003505 | Orphan claim re-pointed Claims processor | CLM-421258 → UHC-61130-89 (Dorothy Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003506 | Orphan claim re-pointed Claims processor | CLM-423999 → UHC-92254-86 (Frank Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003507 | Orphan claim re-pointed Claims processor | CLM-400067 → UHC-78966-48 (Lawrence Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003508 | Orphan claim re-pointed Claims processor | CLM-407789 → UHC-11426-40 (Kenneth Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003509 | Orphan claim re-pointed Claims processor | CLM-405403 → UHC-53023-13 (Jerry Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003510 | Orphan claim re-pointed Claims processor | CLM-408225 → UHC-24001-25 (Sandra Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003511 | Orphan claim re-pointed Claims processor | CLM-422142 → UHC-88614-34 (Joan Edwards) |
| 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.