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-003562 | Orphan claim re-pointed Claims processor | CLM-412128 → UHC-77128-20 (Ruth Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003563 | Orphan claim re-pointed Claims processor | CLM-402443 → UHC-50096-50 (Josh Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003564 | Orphan claim re-pointed Claims processor | CLM-410596 → UHC-37511-88 (Marcus Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003565 | Orphan claim re-pointed Claims processor | CLM-420980 → UHC-63371-59 (Andrew Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003566 | Orphan claim re-pointed Claims processor | CLM-402752 → UHC-48982-35 (Charlotte Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003567 | Orphan claim re-pointed Claims processor | CLM-422853 → UHC-87121-87 (Julia Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003568 | Orphan claim re-pointed Claims processor | CLM-402568 → UHC-48696-50 (Mateo Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003569 | Orphan claim re-pointed Claims processor | CLM-432311 → UHC-35129-23 (Ashley Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003570 | Orphan claim re-pointed Claims processor | CLM-424780 → UHC-73125-87 (Gabriel Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003571 | Orphan claim re-pointed Claims processor | CLM-429399 → UHC-04988-64 (Theresa Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003572 | Orphan claim re-pointed Claims processor | CLM-402262 → UHC-43857-58 (Sofia Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003573 | Orphan claim re-pointed Claims processor | CLM-406803 → UHC-22406-82 (Jacob King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003574 | Orphan claim re-pointed Claims processor | CLM-429798 → UHC-88610-44 (Sandra Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003575 | Orphan claim re-pointed Claims processor | CLM-405208 → UHC-38844-27 (Charlotte Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003576 | Orphan claim re-pointed Claims processor | CLM-414863 → UHC-49725-20 (Gloriia Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003577 | Orphan claim re-pointed Claims processor | CLM-432371 → UHC-01616-25 (Deborah Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003578 | Orphan claim re-pointed Claims processor | CLM-401737 → UHC-23813-69 (John Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003579 | Orphan claim re-pointed Claims processor | CLM-428847 → UHC-37940-69 (Kelly Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003580 | Orphan claim re-pointed Claims processor | CLM-402486 → UHC-09549-37 (Brittany Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003581 | Orphan claim re-pointed Claims processor | CLM-417914 → UHC-78083-57 (Judith West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003582 | Orphan claim re-pointed Claims processor | CLM-417115 → UHC-39302-26 (Julia Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003583 | Orphan claim re-pointed Claims processor | CLM-409948 → UHC-02793-47 (Mariana Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003584 | Orphan claim re-pointed Claims processor | CLM-414675 → UHC-72940-64 (Sophia Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003585 | Orphan claim re-pointed Claims processor | CLM-421378 → UHC-70202-76 (Dylan Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003586 | Orphan claim re-pointed Claims processor | CLM-412256 → UHC-96793-99 (Jacob Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003587 | Orphan claim re-pointed Claims processor | CLM-427983 → UHC-06532-92 (Abigail Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003588 | Orphan claim re-pointed Claims processor | CLM-432700 → UHC-63213-69 (Rebecca Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003589 | Orphan claim re-pointed Claims processor | CLM-431673 → UHC-97988-09 (Jacqueline Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003590 | Orphan claim re-pointed Claims processor | CLM-431051 → UHC-73405-81 (Andrew Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003591 | Orphan claim re-pointed Claims processor | CLM-403731 → UHC-53980-36 (Jessica Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003592 | Orphan claim re-pointed Claims processor | CLM-431736 → UHC-18114-77 (Arthur Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003593 | Orphan claim re-pointed Claims processor | CLM-406057 → UHC-64556-29 (Zachary Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003594 | Orphan claim re-pointed Claims processor | CLM-412118 → UHC-38053-93 (Aaron Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003595 | Orphan claim re-pointed Claims processor | CLM-420326 → UHC-58353-57 (Drew Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003596 | Orphan claim re-pointed Claims processor | CLM-420960 → UHC-52307-49 (William Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003597 | Orphan claim re-pointed Claims processor | CLM-401901 → UHC-39209-26 (Samuel Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003598 | Orphan claim re-pointed Claims processor | CLM-421045 → UHC-99344-22 (Joshua Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003599 | Orphan claim re-pointed Claims processor | CLM-401740 → UHC-00302-33 (Teresa Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003600 | Orphan claim re-pointed Claims processor | CLM-424552 → UHC-69765-55 (Blily Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003601 | Orphan claim re-pointed Claims processor | CLM-426494 → UHC-80724-56 (Amanda McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003602 | Orphan claim re-pointed Claims processor | CLM-404151 → UHC-49265-38 (Paul Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003603 | Orphan claim re-pointed Claims processor | CLM-428999 → UHC-30649-64 (Mason Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003604 | Orphan claim re-pointed Claims processor | CLM-414183 → UHC-78903-55 (Emma Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003605 | Orphan claim re-pointed Claims processor | CLM-421649 → UHC-53180-18 (Mark Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003606 | Orphan claim re-pointed Claims processor | CLM-406352 → UHC-40218-11 (Angela Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003607 | Orphan claim re-pointed Claims processor | CLM-426142 → UHC-74179-83 (Terry Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003608 | Orphan claim re-pointed Claims processor | CLM-403905 → UHC-12107-12 (Ralph Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003609 | Orphan claim re-pointed Claims processor | CLM-429715 → UHC-38570-43 (Gloria Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003610 | Orphan claim re-pointed Claims processor | CLM-421533 → UHC-20155-17 (Gregory Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003611 | Orphan claim re-pointed Claims processor | CLM-409291 → UHC-43144-61 (Benjamin Moreno) |
| 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.