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-003912 | Orphan claim re-pointed Claims processor | CLM-400057 → UHC-53829-66 (Laura Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003913 | Orphan claim re-pointed Claims processor | CLM-404412 → UHC-70105-62 (Jeffrey Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003914 | Orphan claim re-pointed Claims processor | CLM-402729 → UHC-92968-09 (Ana Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003915 | Orphan claim re-pointed Claims processor | CLM-405474 → UHC-39661-50 (Albert Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003916 | Orphan claim re-pointed Claims processor | CLM-407390 → UHC-52903-44 (Philip Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003917 | Orphan claim re-pointed Claims processor | CLM-402043 → UHC-47109-16 (Scott Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003918 | Orphan claim re-pointed Claims processor | CLM-425071 → UHC-85183-78 (Joan Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003919 | Orphan claim re-pointed Claims processor | CLM-413068 → UHC-57923-64 (Stephen Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003920 | Orphan claim re-pointed Claims processor | CLM-403995 → UHC-55267-90 (Virginia Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003921 | Orphan claim re-pointed Claims processor | CLM-418035 → UHC-77509-21 (William Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003922 | Orphan claim re-pointed Claims processor | CLM-427170 → UHC-11439-98 (Bryan Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003923 | Orphan claim re-pointed Claims processor | CLM-405615 → UHC-02617-99 (Amber Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003924 | Orphan claim re-pointed Claims processor | CLM-407696 → UHC-94741-69 (Robert Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003925 | Orphan claim re-pointed Claims processor | CLM-419832 → UHC-52792-25 (Daniel Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003926 | Orphan claim re-pointed Claims processor | CLM-407162 → UHC-30657-74 (Ryan Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003927 | Orphan claim re-pointed Claims processor | CLM-421455 → UHC-93320-87 (Bruce Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003928 | Orphan claim re-pointed Claims processor | CLM-418817 → UHC-15997-66 (Henry Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003929 | Orphan claim re-pointed Claims processor | CLM-430868 → UHC-22981-87 (Dennis Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003930 | Orphan claim re-pointed Claims processor | CLM-420752 → UHC-54629-26 (Mariana Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003931 | Orphan claim re-pointed Claims processor | CLM-431204 → UHC-59050-84 (Bradley Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003932 | Orphan claim re-pointed Claims processor | CLM-423663 → UHC-34876-67 (Eugene Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003933 | Orphan claim re-pointed Claims processor | CLM-411251 → UHC-98163-77 (Heather Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003934 | Orphan claim re-pointed Claims processor | CLM-411626 → UHC-14707-79 (Santiago Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003935 | Orphan claim re-pointed Claims processor | CLM-403696 → UHC-19046-98 (Christina Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003936 | Orphan claim re-pointed Claims processor | CLM-420518 → UHC-74228-68 (Abbby Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003937 | Orphan claim re-pointed Claims processor | CLM-429774 → UHC-49905-75 (Kathryn Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003938 | Orphan claim re-pointed Claims processor | CLM-402648 → UHC-17562-29 (George Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003939 | Orphan claim re-pointed Claims processor | CLM-428938 → UHC-10473-09 (Victoria Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003940 | Orphan claim re-pointed Claims processor | CLM-408433 → UHC-85118-52 (Ryan Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003941 | Orphan claim re-pointed Claims processor | CLM-427012 → UHC-97621-91 (Christian Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003942 | Orphan claim re-pointed Claims processor | CLM-413818 → UHC-52249-72 (Ann Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003943 | Orphan claim re-pointed Claims processor | CLM-424829 → UHC-60006-41 (Jose Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003944 | Orphan claim re-pointed Claims processor | CLM-410390 → UHC-16414-38 (Elijah Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003945 | Orphan claim re-pointed Claims processor | CLM-430445 → UHC-20978-25 (Bradley Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003946 | Orphan claim re-pointed Claims processor | CLM-427052 → UHC-32542-57 (Bryan Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003947 | Orphan claim re-pointed Claims processor | CLM-402880 → UHC-00431-81 (Diego Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003948 | Orphan claim re-pointed Claims processor | CLM-408668 → UHC-47109-24 (Ruth Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003949 | Orphan claim re-pointed Claims processor | CLM-429519 → UHC-80595-34 (Julia Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003950 | Orphan claim re-pointed Claims processor | CLM-401231 → UHC-31772-12 (Dennis Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003951 | Orphan claim re-pointed Claims processor | CLM-432038 → UHC-60754-75 (Bobby Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003952 | Orphan claim re-pointed Claims processor | CLM-416463 → UHC-05917-75 (Fatima Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003953 | Orphan claim re-pointed Claims processor | CLM-401681 → UHC-35149-69 (Abigail Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003954 | Orphan claim re-pointed Claims processor | CLM-414397 → UHC-35055-55 (Santiago Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003955 | Orphan claim re-pointed Claims processor | CLM-400399 → UHC-54640-63 (Shirley Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003956 | Orphan claim re-pointed Claims processor | CLM-405552 → UHC-62944-73 (Sara Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003957 | Orphan claim re-pointed Claims processor | CLM-418694 → UHC-08743-28 (Daniel Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003958 | Orphan claim re-pointed Claims processor | CLM-430164 → UHC-29214-49 (Raymond Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003959 | Orphan claim re-pointed Claims processor | CLM-420395 → UHC-34681-43 (Christian Simmonns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003960 | Orphan claim re-pointed Claims processor | CLM-408815 → UHC-84410-24 (Victoria Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003961 | Orphan claim re-pointed Claims processor | CLM-406704 → UHC-66427-98 (Laura Murray) |
| 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.