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-003662 | Orphan claim re-pointed Claims processor | CLM-421805 → UHC-53009-43 (Helen Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003663 | Orphan claim re-pointed Claims processor | CLM-405989 → UHC-44961-96 (Joshua Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003664 | Orphan claim re-pointed Claims processor | CLM-409659 → UHC-58614-40 (Alexander Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003665 | Orphan claim re-pointed Claims processor | CLM-427248 → UHC-50874-41 (Bruce Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003666 | Orphan claim re-pointed Claims processor | CLM-410039 → UHC-72396-45 (Jason Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003667 | Orphan claim re-pointed Claims processor | CLM-409229 → UHC-28152-67 (Joe Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003668 | Orphan claim re-pointed Claims processor | CLM-423702 → UHC-81831-31 (Kathleen Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003669 | Orphan claim re-pointed Claims processor | CLM-423118 → UHC-47110-21 (Barbara Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003670 | Orphan claim re-pointed Claims processor | CLM-406790 → UHC-28167-34 (Jacqueline Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003671 | Orphan claim re-pointed Claims processor | CLM-411670 → UHC-67995-44 (Donna Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003672 | Orphan claim re-pointed Claims processor | CLM-417822 → UHC-89751-57 (Aisha Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003673 | Orphan claim re-pointed Claims processor | CLM-403008 → UHC-91652-15 (Ryan Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003674 | Orphan claim re-pointed Claims processor | CLM-422829 → UHC-77203-39 (Elijah Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003675 | Orphan claim re-pointed Claims processor | CLM-405768 → UHC-27527-73 (Henry Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003676 | Orphan claim re-pointed Claims processor | CLM-415123 → UHC-96249-54 (Timothy Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003677 | Orphan claim re-pointed Claims processor | CLM-421001 → UHC-02986-81 (Tyler Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003678 | Orphan claim re-pointed Claims processor | CLM-402132 → UHC-01248-43 (Diane Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003679 | Orphan claim re-pointed Claims processor | CLM-419903 → UHC-69124-67 (Kathryn Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003680 | Orphan claim re-pointed Claims processor | CLM-424012 → UHC-97185-04 (Marcus Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003681 | Orphan claim re-pointed Claims processor | CLM-401254 → UHC-20075-24 (Maria Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003682 | Orphan claim re-pointed Claims processor | CLM-428231 → UHC-45079-43 (Jerry Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003683 | Orphan claim re-pointed Claims processor | CLM-417403 → UHC-29632-13 (Terry Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003684 | Orphan claim re-pointed Claims processor | CLM-404071 → UHC-81271-92 (Ryan Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003685 | Orphan claim re-pointed Claims processor | CLM-401546 → UHC-15951-28 (Michael Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003686 | Orphan claim re-pointed Claims processor | CLM-401003 → UHC-52621-90 (Charles Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003687 | Orphan claim re-pointed Claims processor | CLM-418217 → UHC-15372-66 (Jason Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003688 | Orphan claim re-pointed Claims processor | CLM-412241 → UHC-40023-82 (Victoria Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003689 | Orphan claim re-pointed Claims processor | CLM-430699 → UHC-62633-54 (Alexnader Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003690 | Orphan claim re-pointed Claims processor | CLM-419355 → UHC-07141-01 (Wei Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003691 | Orphan claim re-pointed Claims processor | CLM-432210 → UHC-97503-27 (Stephanie Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003692 | Orphan claim re-pointed Claims processor | CLM-418686 → UHC-41801-41 (Samuel Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003693 | Orphan claim re-pointed Claims processor | CLM-412774 → UHC-00600-28 (Walter Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003694 | Orphan claim re-pointed Claims processor | CLM-404804 → UHC-90669-86 (Kyle Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003695 | Orphan claim re-pointed Claims processor | CLM-427030 → UHC-80375-81 (Christopher Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003696 | Orphan claim re-pointed Claims processor | CLM-415284 → UHC-11422-31 (Justin Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003697 | Orphan claim re-pointed Claims processor | CLM-419220 → UHC-20139-14 (Alice Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003698 | Orphan claim re-pointed Claims processor | CLM-401829 → UHC-36535-42 (Teresa Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003699 | Orphan claim re-pointed Claims processor | CLM-418134 → UHC-27839-97 (Teresa Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003700 | Orphan claim re-pointed Claims processor | CLM-404102 → UHC-42358-35 (Dorothy Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003701 | Orphan claim re-pointed Claims processor | CLM-422813 → UHC-75951-23 (Natalie Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003702 | Orphan claim re-pointed Claims processor | CLM-410622 → UHC-17328-79 (Russell Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003703 | Orphan claim re-pointed Claims processor | CLM-417670 → UHC-79356-55 (Arjun Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003704 | Orphan claim re-pointed Claims processor | CLM-423152 → UHC-88270-98 (Jeremy Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003705 | Orphan claim re-pointed Claims processor | CLM-427491 → UHC-29672-58 (Kyle Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003706 | Orphan claim re-pointed Claims processor | CLM-401693 → UHC-95789-74 (Arthur Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003707 | Orphan claim re-pointed Claims processor | CLM-432359 → UHC-92182-66 (Jose Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003708 | Orphan claim re-pointed Claims processor | CLM-429084 → UHC-94555-31 (Mariana Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003709 | Orphan claim re-pointed Claims processor | CLM-407911 → UHC-27271-24 (Frank Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003710 | Orphan claim re-pointed Claims processor | CLM-404967 → UHC-50684-94 (Sam Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003711 | Orphan claim re-pointed Claims processor | CLM-408746 → UHC-51290-92 (Gerald Rose) |
| 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.