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-003862 | Orphan claim re-pointed Claims processor | CLM-405588 → UHC-14844-78 (Omar Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003863 | Orphan claim re-pointed Claims processor | CLM-418689 → UHC-19774-93 (Billy Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003864 | Orphan claim re-pointed Claims processor | CLM-404558 → UHC-32163-09 (Beverly Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003865 | Orphan claim re-pointed Claims processor | CLM-420622 → UHC-84264-29 (Willie Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003866 | Orphan claim re-pointed Claims processor | CLM-431222 → UHC-81537-62 (Donna Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003867 | Orphan claim re-pointed Claims processor | CLM-408238 → UHC-94226-56 (Julia Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003868 | Orphan claim re-pointed Claims processor | CLM-422919 → UHC-53530-87 (Alexis Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003869 | Orphan claim re-pointed Claims processor | CLM-428608 → UHC-63078-75 (Madison Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003870 | Orphan claim re-pointed Claims processor | CLM-402711 → UHC-98906-09 (Kayla Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003871 | Orphan claim re-pointed Claims processor | CLM-414319 → UHC-19095-82 (Jlie Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003872 | Orphan claim re-pointed Claims processor | CLM-414718 → UHC-58402-80 (Brandon Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003873 | Orphan claim re-pointed Claims processor | CLM-413041 → UHC-65942-65 (Jeremy Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003874 | Orphan claim re-pointed Claims processor | CLM-420447 → UHC-93836-29 (Patrick Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003875 | Orphan claim re-pointed Claims processor | CLM-403298 → UHC-95245-95 (Vincent Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003876 | Orphan claim re-pointed Claims processor | CLM-418493 → UHC-44883-09 (Alexander Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003877 | Orphan claim re-pointed Claims processor | CLM-403852 → UHC-60731-35 (Larry Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003878 | Orphan claim re-pointed Claims processor | CLM-410411 → UHC-67569-91 (Teresa Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003879 | Orphan claim re-pointed Claims processor | CLM-418848 → UHC-34859-38 (Jeremy Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003880 | Orphan claim re-pointed Claims processor | CLM-422507 → UHC-07710-68 (Willie Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003881 | Orphan claim re-pointed Claims processor | CLM-404707 → UHC-32418-96 (Yuki Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003882 | Orphan claim re-pointed Claims processor | CLM-409792 → UHC-60029-17 (Jacqueline Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003883 | Orphan claim re-pointed Claims processor | CLM-421833 → UHC-36825-92 (Larry Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003884 | Orphan claim re-pointed Claims processor | CLM-426323 → UHC-99703-83 (Gloria Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003885 | Orphan claim re-pointed Claims processor | CLM-424554 → UHC-35421-78 (Santiago Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003886 | Orphan claim re-pointed Claims processor | CLM-416973 → UHC-42690-59 (Jose Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003887 | Orphan claim re-pointed Claims processor | CLM-409768 → UHC-58917-79 (Elijah Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003888 | Orphan claim re-pointed Claims processor | CLM-408053 → UHC-56097-83 (Thomas Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003889 | Orphan claim re-pointed Claims processor | CLM-400408 → UHC-06862-81 (Aaron Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003890 | Orphan claim re-pointed Claims processor | CLM-406623 → UHC-53630-10 (Kathleen Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003891 | Orphan claim re-pointed Claims processor | CLM-419710 → UHC-99410-20 (Abby Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003892 | Orphan claim re-pointed Claims processor | CLM-403941 → UHC-72695-92 (Elijah Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003893 | Orphan claim re-pointed Claims processor | CLM-412579 → UHC-11667-88 (Shirley Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003894 | Orphan claim re-pointed Claims processor | CLM-410096 → UHC-65603-12 (Gary Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003895 | Orphan claim re-pointed Claims processor | CLM-405380 → UHC-83550-98 (Anthony Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003896 | Orphan claim re-pointed Claims processor | CLM-412227 → UHC-54651-03 (Megan Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003897 | Orphan claim re-pointed Claims processor | CLM-408061 → UHC-99058-30 (Bruce Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003898 | Orphan claim re-pointed Claims processor | CLM-408258 → UHC-22039-25 (Walter Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003899 | Orphan claim re-pointed Claims processor | CLM-412765 → UHC-87809-79 (Steven Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003900 | Orphan claim re-pointed Claims processor | CLM-405128 → UHC-49921-75 (Denise Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003901 | Orphan claim re-pointed Claims processor | CLM-417329 → UHC-18243-61 (Michael Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003902 | Orphan claim re-pointed Claims processor | CLM-413980 → UHC-58277-73 (Samuel Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003903 | Orphan claim re-pointed Claims processor | CLM-424077 → UHC-63640-79 (Priya Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003904 | Orphan claim re-pointed Claims processor | CLM-409605 → UHC-12032-61 (Catherine Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003905 | Orphan claim re-pointed Claims processor | CLM-428773 → UHC-33961-52 (Aaron Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003906 | Orphan claim re-pointed Claims processor | CLM-417140 → UHC-77504-30 (Valentina Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003907 | Orphan claim re-pointed Claims processor | CLM-406622 → UHC-53630-10 (Kathleen Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003908 | Orphan claim re-pointed Claims processor | CLM-432817 → UHC-87647-23 (Brittany Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003909 | Orphan claim re-pointed Claims processor | CLM-403624 → UHC-49193-58 (Jack Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003910 | Orphan claim re-pointed Claims processor | CLM-406128 → UHC-68864-27 (Michelle Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003911 | Orphan claim re-pointed Claims processor | CLM-424707 → UHC-79738-91 (Nathan Yang) |
| 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.