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-004412 | Orphan claim re-pointed Claims processor | CLM-413133 → UHC-00195-62 (Danielle Vassquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004413 | Orphan claim re-pointed Claims processor | CLM-416032 → UHC-60936-79 (Marcus Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004414 | Orphan claim re-pointed Claims processor | CLM-403906 → UHC-09193-61 (Jason Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004415 | Orphan claim re-pointed Claims processor | CLM-429359 → UHC-23298-02 (Margaret Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004416 | Orphan claim re-pointed Claims processor | CLM-411628 → UHC-39760-20 (Arthur Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004417 | Orphan claim re-pointed Claims processor | CLM-401416 → UHC-75918-34 (Bryan Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004418 | Orphan claim re-pointed Claims processor | CLM-425885 → UHC-33591-20 (Bryan Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004419 | Orphan claim re-pointed Claims processor | CLM-404690 → UHC-10206-05 (Ahmed Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004420 | Orphan claim re-pointed Claims processor | CLM-421931 → UHC-83588-76 (Maria Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004421 | Orphan claim re-pointed Claims processor | CLM-423445 → UHC-88293-04 (Larry Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004422 | Orphan claim re-pointed Claims processor | CLM-411918 → UHC-29398-05 (Julia Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004423 | Orphan claim re-pointed Claims processor | CLM-423614 → UHC-70899-35 (Joan Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004424 | Orphan claim re-pointed Claims processor | CLM-422092 → UHC-62136-56 (Luis Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004425 | Orphan claim re-pointed Claims processor | CLM-430241 → UHC-83901-95 (Austin Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004426 | Orphan claim re-pointed Claims processor | CLM-419606 → UHC-82844-75 (Amy Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004427 | Orphan claim re-pointed Claims processor | CLM-400185 → UHC-36965-72 (Anthony Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004428 | Orphan claim re-pointed Claims processor | CLM-421676 → UHC-33647-05 (Janice Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004429 | Orphan claim re-pointed Claims processor | CLM-401877 → UHC-75417-10 (Isabella Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004430 | Orphan claim re-pointed Claims processor | CLM-423398 → UHC-08669-16 (Vicky Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004431 | Orphan claim re-pointed Claims processor | CLM-413182 → UHC-64287-90 (Roy Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004432 | Orphan claim re-pointed Claims processor | CLM-404395 → UHC-80671-65 (Ralph Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004433 | Orphan claim re-pointed Claims processor | CLM-401430 → UHC-26415-69 (Willie Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004434 | Orphan claim re-pointed Claims processor | CLM-414841 → UHC-23904-16 (Elijah Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004435 | Orphan claim re-pointed Claims processor | CLM-409211 → UHC-45965-92 (Jeffrey Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004436 | Orphan claim re-pointed Claims processor | CLM-423452 → UHC-80479-97 (Amber Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004437 | Orphan claim re-pointed Claims processor | CLM-404789 → UHC-91040-77 (Bradley Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004438 | Orphan claim re-pointed Claims processor | CLM-411972 → UHC-26604-40 (Jesse Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004439 | Orphan claim re-pointed Claims processor | CLM-425088 → UHC-27960-11 (Joan Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004440 | Orphan claim re-pointed Claims processor | CLM-427544 → UHC-28198-68 (Marilyn George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004441 | Orphan claim re-pointed Claims processor | CLM-409764 → UHC-81594-70 (Heather Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004442 | Orphan claim re-pointed Claims processor | CLM-412642 → UHC-66069-07 (Olivia Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004443 | Orphan claim re-pointed Claims processor | CLM-426899 → UHC-76883-32 (Ethan Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004444 | Orphan claim re-pointed Claims processor | CLM-407943 → UHC-25891-17 (Jeremy Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004445 | Orphan claim re-pointed Claims processor | CLM-420978 → UHC-04062-47 (Ronald Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004446 | Orphan claim re-pointed Claims processor | CLM-404702 → UHC-03406-45 (Joseph Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004447 | Orphan claim re-pointed Claims processor | CLM-416837 → UHC-19314-17 (Terry Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004448 | Orphan claim re-pointed Claims processor | CLM-428737 → UHC-38311-79 (Pamela Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004449 | Orphan claim re-pointed Claims processor | CLM-401450 → UHC-43441-53 (Melissa Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004450 | Orphan claim re-pointed Claims processor | CLM-413585 → UHC-05076-98 (Christian Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004451 | Orphan claim re-pointed Claims processor | CLM-408300 → UHC-60955-24 (Michelle Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004452 | Orphan claim re-pointed Claims processor | CLM-405625 → UHC-30686-19 (Timothy Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004453 | Orphan claim re-pointed Claims processor | CLM-407896 → UHC-52556-86 (Dennis Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004454 | Orphan claim re-pointed Claims processor | CLM-424245 → UHC-43737-02 (Gabriel Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004455 | Orphan claim re-pointed Claims processor | CLM-429232 → UHC-12565-68 (Sofia Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004456 | Orphan claim re-pointed Claims processor | CLM-425974 → UHC-38228-80 (Tyler Myres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004457 | Orphan claim re-pointed Claims processor | CLM-416891 → UHC-26251-27 (Natalie Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004458 | Orphan claim re-pointed Claims processor | CLM-415525 → UHC-23280-93 (Philip Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004459 | Orphan claim re-pointed Claims processor | CLM-418893 → UHC-58135-07 (Gloria Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004460 | Orphan claim re-pointed Claims processor | CLM-427640 → UHC-57924-01 (Shirley Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004461 | Orphan claim re-pointed Claims processor | CLM-409688 → UHC-35048-99 (Aaron Taylor) |
| 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.