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-004162 | Orphan claim re-pointed Claims processor | CLM-415913 → UHC-83792-17 (Harold Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004163 | Orphan claim re-pointed Claims processor | CLM-405444 → UHC-87174-74 (Jason Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004164 | Orphan claim re-pointed Claims processor | CLM-421536 → UHC-32156-74 (Christian Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004165 | Orphan claim re-pointed Claims processor | CLM-418420 → UHC-78519-23 (Joseph Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004166 | Orphan claim re-pointed Claims processor | CLM-424050 → UHC-34140-62 (Dorothy Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004167 | Orphan claim re-pointed Claims processor | CLM-409699 → UHC-03553-42 (Crawford Lori) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004168 | Orphan claim re-pointed Claims processor | CLM-409480 → UHC-25227-10 (Kyle Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004169 | Orphan claim re-pointed Claims processor | CLM-420260 → UHC-55158-75 (Joe Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004170 | Orphan claim re-pointed Claims processor | CLM-422069 → UHC-12199-64 (Fatima Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004171 | Orphan claim re-pointed Claims processor | CLM-406853 → UHC-15169-15 (Jerry Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004172 | Orphan claim re-pointed Claims processor | CLM-415332 → UHC-84180-72 (Nancy Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004173 | Orphan claim re-pointed Claims processor | CLM-416096 → UHC-12370-45 (Sandra Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004174 | Orphan claim re-pointed Claims processor | CLM-401323 → UHC-24513-24 (Helen Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004175 | Orphan claim re-pointed Claims processor | CLM-404290 → UHC-81208-98 (Joseph Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004176 | Orphan claim re-pointed Claims processor | CLM-421148 → UHC-58570-09 (Maria Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004177 | Orphan claim re-pointed Claims processor | CLM-406019 → UHC-73426-48 (Kayla Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004178 | Orphan claim re-pointed Claims processor | CLM-428333 → UHC-38072-86 (Danielle Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004179 | Orphan claim re-pointed Claims processor | CLM-422604 → UHC-33618-37 (Dylan Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004180 | Orphan claim re-pointed Claims processor | CLM-427566 → UHC-60412-92 (Barbara Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004181 | Orphan claim re-pointed Claims processor | CLM-414799 → UHC-81288-01 (Billy Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004182 | Orphan claim re-pointed Claims processor | CLM-418542 → UHC-42672-48 (Kayla Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004183 | Orphan claim re-pointed Claims processor | CLM-425463 → UHC-08732-87 (Teresa Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004184 | Orphan claim re-pointed Claims processor | CLM-416041 → UHC-11060-89 (Kathryn Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004185 | Orphan claim re-pointed Claims processor | CLM-425832 → UHC-92716-76 (Anna Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004186 | Orphan claim re-pointed Claims processor | CLM-413514 → UHC-59451-69 (Brian Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004187 | Orphan claim re-pointed Claims processor | CLM-402717 → UHC-78593-05 (Wayne Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004188 | Orphan claim re-pointed Claims processor | CLM-413466 → UHC-08157-31 (Mark Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004189 | Orphan claim re-pointed Claims processor | CLM-414803 → UHC-45571-88 (Bradley Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004190 | Orphan claim re-pointed Claims processor | CLM-427268 → UHC-86503-69 (Kyle Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004191 | Orphan claim re-pointed Claims processor | CLM-415674 → UHC-46209-94 (Jacqueline Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004192 | Orphan claim re-pointed Claims processor | CLM-412110 → UHC-60017-55 (Jack Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004193 | Orphan claim re-pointed Claims processor | CLM-427760 → UHC-19644-11 (Kimberly Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004194 | Orphan claim re-pointed Claims processor | CLM-428116 → UHC-53383-79 (Priya Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004195 | Orphan claim re-pointed Claims processor | CLM-400391 → UHC-22221-92 (Ethan Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004196 | Orphan claim re-pointed Claims processor | CLM-423395 → UHC-06537-09 (Grace Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004197 | Orphan claim re-pointed Claims processor | CLM-406235 → UHC-00189-24 (Victoria Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004198 | Orphan claim re-pointed Claims processor | CLM-420209 → UHC-43747-98 (Benjamin Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004199 | Orphan claim re-pointed Claims processor | CLM-421501 → UHC-52381-87 (James Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004200 | Orphan claim re-pointed Claims processor | CLM-401974 → UHC-69978-94 (Justin Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004201 | Orphan claim re-pointed Claims processor | CLM-402118 → UHC-74464-51 (Ray Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004202 | Orphan claim re-pointed Claims processor | CLM-415617 → UHC-04889-62 (Linda Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004203 | Orphan claim re-pointed Claims processor | CLM-425774 → UHC-21911-64 (Joan Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004204 | Orphan claim re-pointed Claims processor | CLM-415511 → UHC-51099-94 (Joyce Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004205 | Orphan claim re-pointed Claims processor | CLM-431345 → UHC-73203-21 (Dorothy Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004206 | Orphan claim re-pointed Claims processor | CLM-409148 → UHC-39053-23 (Zachary Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004207 | Orphan claim re-pointed Claims processor | CLM-402119 → UHC-74464-51 (Ray Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004208 | Orphan claim re-pointed Claims processor | CLM-418018 → UHC-69446-66 (Jennifer Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004209 | Orphan claim re-pointed Claims processor | CLM-418981 → UHC-03519-46 (Mark Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004210 | Orphan claim re-pointed Claims processor | CLM-400670 → UHC-75388-97 (Melissa Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004211 | Orphan claim re-pointed Claims processor | CLM-430465 → UHC-96542-58 (Joyce Sanders) |
| 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.