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-003712 | Orphan claim re-pointed Claims processor | CLM-417617 → UHC-12188-14 (Bobby Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003713 | Orphan claim re-pointed Claims processor | CLM-422537 → UHC-15058-98 (Gary Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003714 | Orphan claim re-pointed Claims processor | CLM-404112 → UHC-02046-10 (Christopher Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003715 | Orphan claim re-pointed Claims processor | CLM-424079 → UHC-90643-40 (Lucia Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003716 | Orphan claim re-pointed Claims processor | CLM-427823 → UHC-64152-85 (Donna Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003717 | Orphan claim re-pointed Claims processor | CLM-406864 → UHC-66518-56 (Amanda Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003718 | Orphan claim re-pointed Claims processor | CLM-404254 → UHC-17859-70 (Patrick Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003719 | Orphan claim re-pointed Claims processor | CLM-426085 → UHC-72772-41 (Margaret Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003720 | Orphan claim re-pointed Claims processor | CLM-407398 → UHC-79627-09 (George Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003721 | Orphan claim re-pointed Claims processor | CLM-410178 → UHC-49111-77 (Henry McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003722 | Orphan claim re-pointed Claims processor | CLM-427934 → UHC-22618-46 (Valentina Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003723 | Orphan claim re-pointed Claims processor | CLM-415861 → UHC-13018-79 (Julie Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003724 | Orphan claim re-pointed Claims processor | CLM-404424 → UHC-54572-42 (Lori White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003725 | Orphan claim re-pointed Claims processor | CLM-428423 → UHC-83322-47 (Martha Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003726 | Orphan claim re-pointed Claims processor | CLM-403233 → UHC-43036-19 (Raymond Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003727 | Orphan claim re-pointed Claims processor | CLM-416580 → UHC-04462-47 (Mason Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003728 | Orphan claim re-pointed Claims processor | CLM-418696 → UHC-48670-60 (Ashley Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003729 | Orphan claim re-pointed Claims processor | CLM-425878 → UHC-17655-21 (Ethan Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003730 | Orphan claim re-pointed Claims processor | CLM-410289 → UHC-74011-36 (Aisha Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003731 | Orphan claim re-pointed Claims processor | CLM-418052 → UHC-70649-18 (Samantha Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003732 | Orphan claim re-pointed Claims processor | CLM-416009 → UHC-55595-67 (Aaron Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003733 | Orphan claim re-pointed Claims processor | CLM-431424 → UHC-19387-98 (Marcus Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003734 | Orphan claim re-pointed Claims processor | CLM-432509 → UHC-81285-76 (Kevin Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003735 | Orphan claim re-pointed Claims processor | CLM-421524 → UHC-01817-18 (Dylan Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003736 | Orphan claim re-pointed Claims processor | CLM-409073 → UHC-57506-28 (Theresa Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003737 | Orphan claim re-pointed Claims processor | CLM-429004 → UHC-69226-82 (Virginia Johnstoon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003738 | Orphan claim re-pointed Claims processor | CLM-411169 → UHC-37663-59 (Russell Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003739 | Orphan claim re-pointed Claims processor | CLM-409723 → UHC-08496-08 (Jonathan Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003740 | Orphan claim re-pointed Claims processor | CLM-430989 → UHC-34794-63 (Dennis Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003741 | Orphan claim re-pointed Claims processor | CLM-422524 → UHC-80393-05 (Sofia Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003742 | Orphan claim re-pointed Claims processor | CLM-404734 → UHC-45165-10 (Anna Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003743 | Orphan claim re-pointed Claims processor | CLM-403465 → UHC-72887-01 (Ethan Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003744 | Orphan claim re-pointed Claims processor | CLM-409986 → UHC-32516-68 (Nicole Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003745 | Orphan claim re-pointed Claims processor | CLM-429546 → UHC-36389-70 (Jacob Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003746 | Orphan claim re-pointed Claims processor | CLM-426920 → UHC-33271-88 (Omar Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003747 | Orphan claim re-pointed Claims processor | CLM-417742 → UHC-87202-79 (Bryan Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003748 | Orphan claim re-pointed Claims processor | CLM-401016 → UHC-41992-20 (Janet Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003749 | Orphan claim re-pointed Claims processor | CLM-412450 → UHC-47662-48 (Kevin Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003750 | Orphan claim re-pointed Claims processor | CLM-400516 → UHC-36510-42 (Laura Evasn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003751 | Orphan claim re-pointed Claims processor | CLM-415657 → UHC-07484-53 (Jack Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003752 | Orphan claim re-pointed Claims processor | CLM-423063 → UHC-20571-96 (Beverly Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003753 | Orphan claim re-pointed Claims processor | CLM-409025 → UHC-17641-98 (Laura Gmez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003754 | Orphan claim re-pointed Claims processor | CLM-420200 → UHC-20155-43 (Mateo Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003755 | Orphan claim re-pointed Claims processor | CLM-421302 → UHC-90488-46 (Amy Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003756 | Orphan claim re-pointed Claims processor | CLM-412545 → UHC-99536-64 (Shirley Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003757 | Orphan claim re-pointed Claims processor | CLM-415257 → UHC-15656-39 (Janet Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003758 | Orphan claim re-pointed Claims processor | CLM-422687 → UHC-56657-20 (Heather Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003759 | Orphan claim re-pointed Claims processor | CLM-401017 → UHC-88238-52 (Melissa Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003760 | Orphan claim re-pointed Claims processor | CLM-403015 → UHC-35766-20 (Lauren Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003761 | Orphan claim re-pointed Claims processor | CLM-414754 → UHC-58349-43 (Andrea Davis) |
| 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.