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-003762 | Orphan claim re-pointed Claims processor | CLM-411311 → UHC-81368-61 (Alexander Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003763 | Orphan claim re-pointed Claims processor | CLM-411671 → UHC-67995-44 (Donna Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003764 | Orphan claim re-pointed Claims processor | CLM-414199 → UHC-77438-22 (Mari Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003765 | Orphan claim re-pointed Claims processor | CLM-430341 → UHC-58887-83 (Raymond Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003766 | Orphan claim re-pointed Claims processor | CLM-405344 → UHC-08356-33 (Mateo Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003767 | Orphan claim re-pointed Claims processor | CLM-427433 → UHC-87575-98 (Maria Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003768 | Orphan claim re-pointed Claims processor | CLM-432381 → UHC-75420-71 (Debra Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003769 | Orphan claim re-pointed Claims processor | CLM-402239 → UHC-06321-35 (Marilyn Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003770 | Orphan claim re-pointed Claims processor | CLM-428071 → UHC-98453-76 (Janice Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003771 | Orphan claim re-pointed Claims processor | CLM-424188 → UHC-25170-71 (Janice Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003772 | Orphan claim re-pointed Claims processor | CLM-422143 → UHC-88614-34 (Joan Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003773 | Orphan claim re-pointed Claims processor | CLM-410534 → UHC-25382-23 (Gary Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003774 | Orphan claim re-pointed Claims processor | CLM-401539 → UHC-06689-67 (Jeffrey Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003775 | Orphan claim re-pointed Claims processor | CLM-420264 → UHC-69476-29 (Christopher Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003776 | Orphan claim re-pointed Claims processor | CLM-410332 → UHC-83733-33 (Ryan Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003777 | Orphan claim re-pointed Claims processor | CLM-425121 → UHC-08596-95 (Kaen Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003778 | Orphan claim re-pointed Claims processor | CLM-411847 → UHC-57625-59 (Beverly Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003779 | Orphan claim re-pointed Claims processor | CLM-404537 → UHC-88580-44 (Lisa Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003780 | Orphan claim re-pointed Claims processor | CLM-428369 → UHC-50527-90 (Scott Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003781 | Orphan claim re-pointed Claims processor | CLM-426172 → UHC-71488-13 (Carl Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003782 | Orphan claim re-pointed Claims processor | CLM-423562 → UHC-16696-69 (Hannah Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003783 | Orphan claim re-pointed Claims processor | CLM-424056 → UHC-25577-22 (Carl Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003784 | Orphan claim re-pointed Claims processor | CLM-426443 → UHC-42495-13 (Doris Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003785 | Orphan claim re-pointed Claims processor | CLM-414859 → UHC-90304-33 (Nancy Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003786 | Orphan claim re-pointed Claims processor | CLM-405942 → UHC-52481-89 (Douglas Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003787 | Orphan claim re-pointed Claims processor | CLM-415072 → UHC-49232-31 (Karen Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003788 | Orphan claim re-pointed Claims processor | CLM-431093 → UHC-97823-17 (Beverly Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003789 | Orphan claim re-pointed Claims processor | CLM-430738 → UHC-47531-25 (Roy Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003790 | Orphan claim re-pointed Claims processor | CLM-430391 → UHC-38492-32 (Keith Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003791 | Orphan claim re-pointed Claims processor | CLM-408003 → UHC-11590-49 (Dennis Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003792 | Orphan claim re-pointed Claims processor | CLM-412459 → UHC-93376-76 (Amy Williiamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003793 | Orphan claim re-pointed Claims processor | CLM-423785 → UHC-24207-80 (Douglas Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003794 | Orphan claim re-pointed Claims processor | CLM-403711 → UHC-01356-46 (Keith Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003795 | Orphan claim re-pointed Claims processor | CLM-404941 → UHC-18678-37 (Carlos Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003796 | Orphan claim re-pointed Claims processor | CLM-431280 → UHC-51097-46 (Hannah Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003797 | Orphan claim re-pointed Claims processor | CLM-432341 → UHC-37561-39 (Walter Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003798 | Orphan claim re-pointed Claims processor | CLM-409044 → UHC-09446-73 (Doris Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003799 | Orphan claim re-pointed Claims processor | CLM-401940 → UHC-82412-81 (Emma Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003800 | Orphan claim re-pointed Claims processor | CLM-426469 → UHC-81117-27 (Bobby Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003801 | Orphan claim re-pointed Claims processor | CLM-413071 → UHC-96798-08 (Roy Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003802 | Orphan claim re-pointed Claims processor | CLM-414602 → UHC-16998-40 (Sharon Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003803 | Orphan claim re-pointed Claims processor | CLM-426369 → UHC-85206-38 (Abigail Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003804 | Orphan claim re-pointed Claims processor | CLM-411768 → UHC-90090-71 (Alice Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003805 | Orphan claim re-pointed Claims processor | CLM-427578 → UHC-61675-14 (Diane Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003806 | Orphan claim re-pointed Claims processor | CLM-410352 → UHC-71413-86 (Sophia Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003807 | Orphan claim re-pointed Claims processor | CLM-421632 → UHC-67576-88 (Will Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003808 | Orphan claim re-pointed Claims processor | CLM-402696 → UHC-47088-15 (Anthony Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003809 | Orphan claim re-pointed Claims processor | CLM-407498 → UHC-94395-87 (Peter Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003810 | Orphan claim re-pointed Claims processor | CLM-403851 → UHC-60731-35 (Larry Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003811 | Orphan claim re-pointed Claims processor | CLM-422684 → UHC-07366-97 (Diego Richardson) |
| 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.