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-004312 | Orphan claim re-pointed Claims processor | CLM-407613 → UHC-02317-39 (Willie Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004313 | Orphan claim re-pointed Claims processor | CLM-426932 → UHC-86886-77 (Brittany Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004314 | Orphan claim re-pointed Claims processor | CLM-412000 → UHC-04366-25 (Jesse Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004315 | Orphan claim re-pointed Claims processor | CLM-420634 → UHC-37443-96 (Camila Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004316 | Orphan claim re-pointed Claims processor | CLM-416541 → UHC-85208-07 (Virginia Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004317 | Orphan claim re-pointed Claims processor | CLM-403386 → UHC-58157-12 (Mergaret Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004318 | Orphan claim re-pointed Claims processor | CLM-430984 → UHC-12148-09 (Arthur Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004319 | Orphan claim re-pointed Claims processor | CLM-400454 → UHC-32643-30 (Nicole Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004320 | Orphan claim re-pointed Claims processor | CLM-409241 → UHC-53081-01 (Brian Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004321 | Orphan claim re-pointed Claims processor | CLM-412162 → UHC-63588-98 (Deborah Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004322 | Orphan claim re-pointed Claims processor | CLM-413605 → UHC-67536-71 (Kevin Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004323 | Orphan claim re-pointed Claims processor | CLM-407812 → UHC-14541-33 (Keith Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004324 | Orphan claim re-pointed Claims processor | CLM-425992 → UHC-41776-91 (Theesa Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004325 | Orphan claim re-pointed Claims processor | CLM-420107 → UHC-26490-13 (Sophia Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004326 | Orphan claim re-pointed Claims processor | CLM-420669 → UHC-83875-27 (Roy Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004327 | Orphan claim re-pointed Claims processor | CLM-407969 → UHC-78349-47 (Samantha Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004328 | Orphan claim re-pointed Claims processor | CLM-411441 → UHC-39705-70 (Jean Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004329 | Orphan claim re-pointed Claims processor | CLM-430987 → UHC-36502-86 (Julie Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004330 | Orphan claim re-pointed Claims processor | CLM-400271 → UHC-25022-82 (Kenneth Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004331 | Orphan claim re-pointed Claims processor | CLM-432819 → UHC-49764-58 (Virginia Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004332 | Orphan claim re-pointed Claims processor | CLM-422480 → UHC-68384-52 (Zachary George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004333 | Orphan claim re-pointed Claims processor | CLM-426564 → UHC-71994-41 (Paul Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004334 | Orphan claim re-pointed Claims processor | CLM-403262 → UHC-56221-72 (Jesse Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004335 | Orphan claim re-pointed Claims processor | CLM-408262 → UHC-46355-36 (Jerry Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004336 | Orphan claim re-pointed Claims processor | CLM-420830 → UHC-35561-40 (Sean Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004337 | Orphan claim re-pointed Claims processor | CLM-429661 → UHC-37303-77 (Christine Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004338 | Orphan claim re-pointed Claims processor | CLM-410566 → UHC-81084-47 (Christine Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004339 | Orphan claim re-pointed Claims processor | CLM-430502 → UHC-98619-77 (Pamela Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004340 | Orphan claim re-pointed Claims processor | CLM-423691 → UHC-53868-27 (Deborah Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004341 | Orphan claim re-pointed Claims processor | CLM-430853 → UHC-82158-14 (Arthur Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004342 | Orphan claim re-pointed Claims processor | CLM-412834 → UHC-48987-35 (William Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004343 | Orphan claim re-pointed Claims processor | CLM-402736 → UHC-99424-41 (Steven Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004344 | Orphan claim re-pointed Claims processor | CLM-429613 → UHC-73897-98 (Mason Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004345 | Orphan claim re-pointed Claims processor | CLM-401780 → UHC-56523-95 (Brenda Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004346 | Orphan claim re-pointed Claims processor | CLM-408292 → UHC-68070-58 (Jesse Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004347 | Orphan claim re-pointed Claims processor | CLM-425900 → UHC-29387-63 (Ashley Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004348 | Orphan claim re-pointed Claims processor | CLM-428241 → UHC-07325-19 (Owens Kyle) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004349 | Orphan claim re-pointed Claims processor | CLM-417332 → UHC-33594-46 (Keith Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004350 | Orphan claim re-pointed Claims processor | CLM-426376 → UHC-99425-15 (Megan Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004351 | Orphan claim re-pointed Claims processor | CLM-429755 → UHC-77817-38 (Ahmed Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004352 | Orphan claim re-pointed Claims processor | CLM-424384 → UHC-83825-17 (Steven Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004353 | Orphan claim re-pointed Claims processor | CLM-430450 → UHC-56379-27 (Henry Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004354 | Orphan claim re-pointed Claims processor | CLM-418418 → UHC-53311-49 (Henry Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004355 | Orphan claim re-pointed Claims processor | CLM-415505 → UHC-91983-24 (Debra Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004356 | Orphan claim re-pointed Claims processor | CLM-412850 → UHC-38547-86 (Kathleen Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004357 | Orphan claim re-pointed Claims processor | CLM-401402 → UHC-65311-64 (Gabriel Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004358 | Orphan claim re-pointed Claims processor | CLM-410769 → UHC-22956-92 (Ahmed Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004359 | Orphan claim re-pointed Claims processor | CLM-406434 → UHC-47879-82 (Philip Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004360 | Orphan claim re-pointed Claims processor | CLM-424952 → UHC-53327-82 (Joan Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004361 | Orphan claim re-pointed Claims processor | CLM-428331 → UHC-32024-80 (Gary Schultz) |
| 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.