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-004062 | Orphan claim re-pointed Claims processor | CLM-431573 → UHC-46069-48 (Catherine Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004063 | Orphan claim re-pointed Claims processor | CLM-421197 → UHC-78690-13 (Madison Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004064 | Orphan claim re-pointed Claims processor | CLM-408757 → UHC-91272-09 (Timothy Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004065 | Orphan claim re-pointed Claims processor | CLM-429173 → UHC-31565-20 (Judy Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004066 | Orphan claim re-pointed Claims processor | CLM-420743 → UHC-36303-02 (Jennifer Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004067 | Orphan claim re-pointed Claims processor | CLM-414349 → UHC-42128-21 (Wei Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004068 | Orphan claim re-pointed Claims processor | CLM-405510 → UHC-23098-85 (Larry Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004069 | Orphan claim re-pointed Claims processor | CLM-428172 → UHC-16590-26 (Jerry Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004070 | Orphan claim re-pointed Claims processor | CLM-429522 → UHC-45561-96 (Aisha Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004071 | Orphan claim re-pointed Claims processor | CLM-405485 → UHC-80478-13 (Luis Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004072 | Orphan claim re-pointed Claims processor | CLM-423386 → UHC-67838-83 (Matthew Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004073 | Orphan claim re-pointed Claims processor | CLM-418404 → UHC-94887-37 (Ann Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004074 | Orphan claim re-pointed Claims processor | CLM-413700 → UHC-94110-47 (Vincent Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004075 | Orphan claim re-pointed Claims processor | CLM-423789 → UHC-71415-88 (Barbara Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004076 | Orphan claim re-pointed Claims processor | CLM-423463 → UHC-49345-21 (James Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004077 | Orphan claim re-pointed Claims processor | CLM-425594 → UHC-44943-48 (Sandra Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004078 | Orphan claim re-pointed Claims processor | CLM-425951 → UHC-55080-97 (Brandon Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004079 | Orphan claim re-pointed Claims processor | CLM-405216 → UHC-80110-73 (Carol Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004080 | Orphan claim re-pointed Claims processor | CLM-402035 → UHC-89943-08 (Martha Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004081 | Orphan claim re-pointed Claims processor | CLM-405760 → UHC-34428-44 (Billy King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004082 | Orphan claim re-pointed Claims processor | CLM-400418 → UHC-84278-91 (Gregory Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004083 | Orphan claim re-pointed Claims processor | CLM-423673 → UHC-93883-15 (Albert Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004084 | Orphan claim re-pointed Claims processor | CLM-430130 → UHC-63557-36 (Amanda Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004085 | Orphan claim re-pointed Claims processor | CLM-424859 → UHC-00317-15 (Stephanie Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004086 | Orphan claim re-pointed Claims processor | CLM-410315 → UHC-23819-12 (Donna Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004087 | Orphan claim re-pointed Claims processor | CLM-428373 → UHC-01467-69 (Ronald Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004088 | Orphan claim re-pointed Claims processor | CLM-408384 → UHC-20007-69 (Joe Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004089 | Orphan claim re-pointed Claims processor | CLM-431228 → UHC-79001-22 (Jeremy Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004090 | Orphan claim re-pointed Claims processor | CLM-412195 → UHC-50591-44 (Andrew Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004091 | Orphan claim re-pointed Claims processor | CLM-418745 → UHC-46631-14 (Marilyn Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004092 | Orphan claim re-pointed Claims processor | CLM-415760 → UHC-95902-85 (Michael Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004093 | Orphan claim re-pointed Claims processor | CLM-405581 → UHC-80972-01 (Hiroshi Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004094 | Orphan claim re-pointed Claims processor | CLM-411406 → UHC-99708-59 (Timothy Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004095 | Orphan claim re-pointed Claims processor | CLM-412610 → UHC-85547-14 (Christopher Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004096 | Orphan claim re-pointed Claims processor | CLM-408858 → UHC-34441-71 (Luis Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004097 | Orphan claim re-pointed Claims processor | CLM-418742 → UHC-17595-06 (Ronald Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004098 | Orphan claim re-pointed Claims processor | CLM-415822 → UHC-68765-36 (Diane Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004099 | Orphan claim re-pointed Claims processor | CLM-402827 → UHC-16007-69 (Ruth Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004100 | Orphan claim re-pointed Claims processor | CLM-418297 → UHC-16985-12 (Linda Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004101 | Orphan claim re-pointed Claims processor | CLM-403371 → UHC-46436-46 (Julia Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004102 | Orphan claim re-pointed Claims processor | CLM-415147 → UHC-51560-75 (Aaron Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004103 | Orphan claim re-pointed Claims processor | CLM-405903 → UHC-32257-08 (Alexander Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004104 | Orphan claim re-pointed Claims processor | CLM-423917 → UHC-10089-20 (Lisa Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004105 | Orphan claim re-pointed Claims processor | CLM-421482 → UHC-78896-24 (Jeffrey Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004106 | Orphan claim re-pointed Claims processor | CLM-426062 → UHC-87673-57 (Amanda Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004107 | Orphan claim re-pointed Claims processor | CLM-424846 → UHC-25707-51 (Michelle Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004108 | Orphan claim re-pointed Claims processor | CLM-429517 → UHC-80595-34 (Julia Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004109 | Orphan claim re-pointed Claims processor | CLM-400800 → UHC-42409-28 (Laura Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004110 | Orphan claim re-pointed Claims processor | CLM-402893 → UHC-01879-27 (Christian Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004111 | Orphan claim re-pointed Claims processor | CLM-429726 → UHC-15473-96 (Charlotte Rojas) |
| 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.