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-004112 | Orphan claim re-pointed Claims processor | CLM-421815 → UHC-31609-15 (Willie Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004113 | Orphan claim re-pointed Claims processor | CLM-417498 → UHC-97981-14 (Emily Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004114 | Orphan claim re-pointed Claims processor | CLM-423968 → UHC-77804-72 (Jonathan Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004115 | Orphan claim re-pointed Claims processor | CLM-404858 → UHC-20418-29 (Arthur Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004116 | Orphan claim re-pointed Claims processor | CLM-427110 → UHC-98826-91 (Isabella Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004117 | Orphan claim re-pointed Claims processor | CLM-405993 → UHC-85275-26 (Lauren Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004118 | Orphan claim re-pointed Claims processor | CLM-421922 → UHC-34912-88 (Theresa Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004119 | Orphan claim re-pointed Claims processor | CLM-412852 → UHC-02361-56 (Judith Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004120 | Orphan claim re-pointed Claims processor | CLM-422228 → UHC-14730-39 (Gerald Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004121 | Orphan claim re-pointed Claims processor | CLM-414280 → UHC-32071-63 (Linda Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004122 | Orphan claim re-pointed Claims processor | CLM-408013 → UHC-05946-53 (Rachel Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004123 | Orphan claim re-pointed Claims processor | CLM-425352 → UHC-78785-52 (Carl Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004124 | Orphan claim re-pointed Claims processor | CLM-411381 → UHC-09658-23 (Jdy Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004125 | Orphan claim re-pointed Claims processor | CLM-405391 → UHC-48174-87 (Andrew Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004126 | Orphan claim re-pointed Claims processor | CLM-412175 → UHC-36745-76 (Sean Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004127 | Orphan claim re-pointed Claims processor | CLM-424716 → UHC-15360-01 (Daniel Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004128 | Orphan claim re-pointed Claims processor | CLM-428919 → UHC-26103-13 (Austin Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004129 | Orphan claim re-pointed Claims processor | CLM-408847 → UHC-95280-49 (Diego Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004130 | Orphan claim re-pointed Claims processor | CLM-419388 → UHC-95109-52 (Shirley Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004131 | Orphan claim re-pointed Claims processor | CLM-405340 → UHC-27600-40 (Luis Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004132 | Orphan claim re-pointed Claims processor | CLM-420432 → UHC-14557-08 (Charles Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004133 | Orphan claim re-pointed Claims processor | CLM-404561 → UHC-45682-55 (David Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004134 | Orphan claim re-pointed Claims processor | CLM-432318 → UHC-10590-48 (Emma Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004135 | Orphan claim re-pointed Claims processor | CLM-402868 → UHC-31158-95 (Danielle Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004136 | Orphan claim re-pointed Claims processor | CLM-424370 → UHC-28455-24 (Peter Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004137 | Orphan claim re-pointed Claims processor | CLM-424928 → UHC-91159-53 (Diane George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004138 | Orphan claim re-pointed Claims processor | CLM-408665 → UHC-99908-37 (Mary George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004139 | Orphan claim re-pointed Claims processor | CLM-411741 → UHC-26060-45 (Priya Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004140 | Orphan claim re-pointed Claims processor | CLM-408726 → UHC-13516-97 (Sean Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004141 | Orphan claim re-pointed Claims processor | CLM-412750 → UHC-22076-21 (Kimberly Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004142 | Orphan claim re-pointed Claims processor | CLM-414666 → UHC-82468-07 (Christine Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004143 | Orphan claim re-pointed Claims processor | CLM-429659 → UHC-35789-57 (Betty Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004144 | Orphan claim re-pointed Claims processor | CLM-423744 → UHC-17038-94 (Jorddan Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004145 | Orphan claim re-pointed Claims processor | CLM-432624 → UHC-30304-46 (Alice Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004146 | Orphan claim re-pointed Claims processor | CLM-427988 → UHC-92885-35 (Sharon Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004147 | Orphan claim re-pointed Claims processor | CLM-414533 → UHC-99901-23 (Patricia Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004148 | Orphan claim re-pointed Claims processor | CLM-413470 → UHC-48919-48 (Anna Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004149 | Orphan claim re-pointed Claims processor | CLM-412381 → UHC-71299-67 (Donald Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004150 | Orphan claim re-pointed Claims processor | CLM-411041 → UHC-71249-10 (Charlotte Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004151 | Orphan claim re-pointed Claims processor | CLM-403145 → UHC-22094-51 (Joshua Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004152 | Orphan claim re-pointed Claims processor | CLM-414699 → UHC-22962-32 (Vincent Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004153 | Orphan claim re-pointed Claims processor | CLM-402341 → UHC-46654-44 (Aisha Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004154 | Orphan claim re-pointed Claims processor | CLM-429051 → UHC-36756-03 (William Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004155 | Orphan claim re-pointed Claims processor | CLM-428476 → UHC-68989-04 (Betty Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004156 | Orphan claim re-pointed Claims processor | CLM-413564 → UHC-64051-25 (Sophia Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004157 | Orphan claim re-pointed Claims processor | CLM-411348 → UHC-31410-22 (Alexander Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004158 | Orphan claim re-pointed Claims processor | CLM-426363 → UHC-65661-91 (Andrew Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004159 | Orphan claim re-pointed Claims processor | CLM-407240 → UHC-32210-74 (Grace Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004160 | Orphan claim re-pointed Claims processor | CLM-428314 → UHC-40862-03 (David Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004161 | Orphan claim re-pointed Claims processor | CLM-408595 → UHC-47574-41 (Tyler McDonald) |
| 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.