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-002340 | Orphan claim re-pointed Claims processor | CLM-416609 → UHC-99673-23 (Brandon Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002341 | Orphan claim re-pointed Claims processor | CLM-401307 → UHC-72865-77 (Lisa Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002342 | Orphan claim re-pointed Claims processor | CLM-421274 → UHC-78003-20 (Janet Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002343 | Orphan claim re-pointed Claims processor | CLM-423755 → UHC-13092-60 (Philip Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002344 | Orphan claim re-pointed Claims processor | CLM-425911 → UHC-33764-63 (Aisha Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002345 | Orphan claim re-pointed Claims processor | CLM-421038 → UHC-85134-32 (Evelyn Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002346 | Orphan claim re-pointed Claims processor | CLM-429627 → UHC-43306-46 (Ruth Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002347 | Orphan claim re-pointed Claims processor | CLM-401104 → UHC-12085-61 (Kathryn Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002348 | Orphan claim re-pointed Claims processor | CLM-428361 → UHC-84690-46 (Bradley Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002349 | Orphan claim re-pointed Claims processor | CLM-416128 → UHC-84057-85 (George Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002350 | Orphan claim re-pointed Claims processor | CLM-430573 → UHC-68224-02 (Ruth Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002351 | Orphan claim re-pointed Claims processor | CLM-417248 → UHC-89202-61 (Russell Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002352 | Orphan claim re-pointed Claims processor | CLM-420695 → UHC-23729-08 (Karen Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002353 | Orphan claim re-pointed Claims processor | CLM-416109 → UHC-25752-79 (Ruth Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002354 | Orphan claim re-pointed Claims processor | CLM-428439 → UHC-06884-65 (Tyler Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002355 | Orphan claim re-pointed Claims processor | CLM-431800 → UHC-08571-74 (Judy Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002356 | Orphan claim re-pointed Claims processor | CLM-416900 → UHC-69945-91 (Douglas Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002357 | Orphan claim re-pointed Claims processor | CLM-412836 → UHC-32565-66 (Arjun Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002358 | Orphan claim re-pointed Claims processor | CLM-421867 → UHC-33583-79 (Noah Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002359 | Orphan claim re-pointed Claims processor | CLM-422823 → UHC-58222-55 (Benjamin Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002360 | Orphan claim re-pointed Claims processor | CLM-405382 → UHC-26745-33 (Arjun Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002361 | Orphan claim re-pointed Claims processor | CLM-409036 → UHC-06691-69 (Joyce Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002362 | Orphan claim re-pointed Claims processor | CLM-400093 → UHC-20548-27 (Christian Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002363 | Orphan claim re-pointed Claims processor | CLM-411635 → UHC-26238-80 (Olivia Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002364 | Orphan claim re-pointed Claims processor | CLM-428727 → UHC-66793-44 (Julie Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002365 | Orphan claim re-pointed Claims processor | CLM-406154 → UHC-38894-44 (Austin Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002366 | Orphan claim re-pointed Claims processor | CLM-408172 → UHC-89231-07 (Virginia Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002367 | Orphan claim re-pointed Claims processor | CLM-409415 → UHC-91857-26 (Kenneth Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002368 | Orphan claim re-pointed Claims processor | CLM-417536 → UHC-80596-07 (Alexis Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002369 | Orphan claim re-pointed Claims processor | CLM-417887 → UHC-80625-58 (Paul Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002370 | Orphan claim re-pointed Claims processor | CLM-407667 → UHC-95333-52 (Kevin Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002371 | Orphan claim re-pointed Claims processor | CLM-425684 → UHC-34145-47 (Scott Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002372 | Orphan claim re-pointed Claims processor | CLM-427375 → UHC-37268-78 (Ana Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002373 | Orphan claim re-pointed Claims processor | CLM-413170 → UHC-56626-27 (Bryan Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002374 | Orphan claim re-pointed Claims processor | CLM-414182 → UHC-37191-90 (Sophia Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002375 | Orphan claim re-pointed Claims processor | CLM-407116 → UHC-33209-09 (Jesse Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002376 | Orphan claim re-pointed Claims processor | CLM-400158 → UHC-50673-74 (Elizabeth Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002377 | Orphan claim re-pointed Claims processor | CLM-419329 → UHC-68157-21 (Ann Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002378 | Orphan claim re-pointed Claims processor | CLM-427863 → UHC-36934-77 (Wayne Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002379 | Orphan claim re-pointed Claims processor | CLM-417566 → UHC-97967-62 (Don Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002380 | Orphan claim re-pointed Claims processor | CLM-400417 → UHC-70906-85 (Stephen Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002381 | Orphan claim re-pointed Claims processor | CLM-427496 → UHC-98629-39 (Logan Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002382 | Orphan claim re-pointed Claims processor | CLM-428400 → UHC-75643-38 (Jeremy Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002383 | Orphan claim re-pointed Claims processor | CLM-414438 → UHC-27182-89 (Wei Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002384 | Orphan claim re-pointed Claims processor | CLM-406107 → UHC-14438-70 (Adam Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002385 | Orphan claim re-pointed Claims processor | CLM-424383 → UHC-28200-70 (Richard Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002386 | Orphan claim re-pointed Claims processor | CLM-407095 → UHC-75104-95 (Ahmed Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002387 | Orphan claim re-pointed Claims processor | CLM-419149 → UHC-18122-11 (Laura Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002388 | Orphan claim re-pointed Claims processor | CLM-408034 → UHC-50421-83 (Steven Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002389 | Orphan claim re-pointed Claims processor | CLM-414402 → UHC-25825-42 (Danielle Ramirez) |
| 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.