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-003962 | Orphan claim re-pointed Claims processor | CLM-407313 → UHC-00130-55 (Thomas Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003963 | Orphan claim re-pointed Claims processor | CLM-402541 → UHC-33344-70 (James Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003964 | Orphan claim re-pointed Claims processor | CLM-408594 → UHC-19554-84 (Steven Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003965 | Orphan claim re-pointed Claims processor | CLM-406442 → UHC-32131-64 (Priya Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003966 | Orphan claim re-pointed Claims processor | CLM-431115 → UHC-09497-55 (Joe Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003967 | Orphan claim re-pointed Claims processor | CLM-402570 → UHC-53180-13 (Andrew Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003968 | Orphan claim re-pointed Claims processor | CLM-404391 → UHC-45040-71 (Joe Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003969 | Orphan claim re-pointed Claims processor | CLM-414961 → UHC-56461-21 (Lucia Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003970 | Orphan claim re-pointed Claims processor | CLM-427186 → UHC-65862-40 (Ahmed Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003971 | Orphan claim re-pointed Claims processor | CLM-411776 → UHC-64477-90 (Eric Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003972 | Orphan claim re-pointed Claims processor | CLM-410372 → UHC-41438-71 (Ralph Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003973 | Orphan claim re-pointed Claims processor | CLM-401024 → UHC-64353-07 (Russell Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003974 | Orphan claim re-pointed Claims processor | CLM-432672 → UHC-22737-23 (Tricia Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003975 | Orphan claim re-pointed Claims processor | CLM-402944 → UHC-71586-40 (Aisha Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003976 | Orphan claim re-pointed Claims processor | CLM-414794 → UHC-40403-01 (Scott Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003977 | Orphan claim re-pointed Claims processor | CLM-411143 → UHC-93282-35 (Brian Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003978 | Orphan claim re-pointed Claims processor | CLM-418528 → UHC-44618-91 (Larry Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003979 | Orphan claim re-pointed Claims processor | CLM-422274 → UHC-90765-54 (James Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003980 | Orphan claim re-pointed Claims processor | CLM-432494 → UHC-82771-64 (Rachel Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003981 | Orphan claim re-pointed Claims processor | CLM-426747 → UHC-83173-41 (Russell Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003982 | Orphan claim re-pointed Claims processor | CLM-407244 → UHC-89997-70 (Deborah Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003983 | Orphan claim re-pointed Claims processor | CLM-423021 → UHC-29418-35 (Hannah Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003984 | Orphan claim re-pointed Claims processor | CLM-426282 → UHC-83107-81 (Nathan Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003985 | Orphan claim re-pointed Claims processor | CLM-410512 → UHC-30571-89 (Brandon Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003986 | Orphan claim re-pointed Claims processor | CLM-422261 → UHC-15358-31 (Omar Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003987 | Orphan claim re-pointed Claims processor | CLM-403579 → UHC-92434-45 (Brittany Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003988 | Orphan claim re-pointed Claims processor | CLM-415587 → UHC-81725-26 (Ralph Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003989 | Orphan claim re-pointed Claims processor | CLM-430455 → UHC-05137-74 (Ralph Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003990 | Orphan claim re-pointed Claims processor | CLM-431427 → UHC-22728-58 (Frances Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003991 | Orphan claim re-pointed Claims processor | CLM-429410 → UHC-13009-12 (Raymond Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003992 | Orphan claim re-pointed Claims processor | CLM-431907 → UHC-49229-90 (Melissa Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003993 | Orphan claim re-pointed Claims processor | CLM-424372 → UHC-51097-26 (Roger Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003994 | Orphan claim re-pointed Claims processor | CLM-402931 → UHC-11323-44 (Gregory Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003995 | Orphan claim re-pointed Claims processor | CLM-413706 → UHC-85465-78 (Beverly Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003996 | Orphan claim re-pointed Claims processor | CLM-400645 → UHC-12852-84 (Willie Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003997 | Orphan claim re-pointed Claims processor | CLM-414426 → UHC-58675-91 (Aisha Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003998 | Orphan claim re-pointed Claims processor | CLM-411076 → UHC-47519-53 (Robert Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003999 | Orphan claim re-pointed Claims processor | CLM-420610 → UHC-72345-89 (Albert Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004000 | Orphan claim re-pointed Claims processor | CLM-426919 → UHC-33271-88 (Omar Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004001 | Orphan claim re-pointed Claims processor | CLM-419896 → UHC-02823-72 (Susan Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004002 | Orphan claim re-pointed Claims processor | CLM-418563 → UHC-01130-29 (Sean Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004003 | Orphan claim re-pointed Claims processor | CLM-422127 → UHC-48770-09 (Mary Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004004 | Orphan claim re-pointed Claims processor | CLM-422264 → UHC-48770-91 (Marilyn Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004005 | Orphan claim re-pointed Claims processor | CLM-429391 → UHC-42496-47 (Emily Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004006 | Orphan claim re-pointed Claims processor | CLM-404606 → UHC-76091-41 (Susan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004007 | Orphan claim re-pointed Claims processor | CLM-426374 → UHC-10097-24 (Sharon Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004008 | Orphan claim re-pointed Claims processor | CLM-412987 → UHC-79196-55 (Olivia Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004009 | Orphan claim re-pointed Claims processor | CLM-407441 → UHC-50936-17 (Evalyn Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004010 | Orphan claim re-pointed Claims processor | CLM-422123 → UHC-31111-49 (Sara Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004011 | Orphan claim re-pointed Claims processor | CLM-408876 → UHC-41515-84 (Bruce Perkins) |
| 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.