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-004462 | Orphan claim re-pointed Claims processor | CLM-411849 → UHC-83217-83 (Denise Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004463 | Orphan claim re-pointed Claims processor | CLM-408589 → UHC-00750-76 (Aisha Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004464 | Orphan claim re-pointed Claims processor | CLM-430305 → UHC-48651-30 (Mariana Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004465 | Orphan claim re-pointed Claims processor | CLM-427314 → UHC-10806-16 (Sharon Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004466 | Orphan claim re-pointed Claims processor | CLM-404700 → UHC-03406-45 (Joseph Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004467 | Orphan claim re-pointed Claims processor | CLM-411659 → UHC-43847-07 (Lisa Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004468 | Orphan claim re-pointed Claims processor | CLM-402142 → UHC-32734-85 (Bruce Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004469 | Orphan claim re-pointed Claims processor | CLM-409024 → UHC-02353-12 (Ray Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004470 | Orphan claim re-pointed Claims processor | CLM-417206 → UHC-13928-11 (Sarah Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004471 | Orphan claim re-pointed Claims processor | CLM-413074 → UHC-81599-10 (Theresa Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004472 | Orphan claim re-pointed Claims processor | CLM-423359 → UHC-80053-21 (Billy Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004473 | Orphan claim re-pointed Claims processor | CLM-431527 → UHC-20779-93 (Amanda Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004474 | Orphan claim re-pointed Claims processor | CLM-409564 → UHC-09486-83 (Carolyn Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004475 | Orphan claim re-pointed Claims processor | CLM-425673 → UHC-63043-32 (Evelyn Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004476 | Orphan claim re-pointed Claims processor | CLM-417467 → UHC-67117-89 (Alice Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004477 | Orphan claim re-pointed Claims processor | CLM-404454 → UHC-92470-78 (Larry Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004478 | Orphan claim re-pointed Claims processor | CLM-401033 → UHC-90615-72 (Zachary Stune) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004479 | Orphan claim re-pointed Claims processor | CLM-408296 → UHC-34471-48 (Teresa Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004480 | Orphan claim re-pointed Claims processor | CLM-412936 → UHC-93843-37 (Carl Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004481 | Orphan claim re-pointed Claims processor | CLM-410016 → UHC-48577-49 (Noah Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004482 | Orphan claim re-pointed Claims processor | CLM-417828 → UHC-66935-98 (Ashley Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004483 | Orphan claim re-pointed Claims processor | CLM-421609 → UHC-45344-03 (Peter Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004484 | Orphan claim re-pointed Claims processor | CLM-417967 → UHC-22549-45 (Jack Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004485 | Orphan claim re-pointed Claims processor | CLM-407901 → UHC-47589-10 (Bradley Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004486 | Orphan claim re-pointed Claims processor | CLM-415316 → UHC-06212-17 (Sara Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004487 | Orphan claim re-pointed Claims processor | CLM-427192 → UHC-75188-27 (Carol Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004488 | Orphan claim re-pointed Claims processor | CLM-409566 → UHC-98542-11 (Jessica Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004489 | Orphan claim re-pointed Claims processor | CLM-430232 → UHC-73394-99 (Carol Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004490 | Orphan claim re-pointed Claims processor | CLM-410960 → UHC-72593-31 (Valentina Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004491 | Orphan claim re-pointed Claims processor | CLM-432728 → UHC-33938-14 (Juan Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004492 | Orphan claim re-pointed Claims processor | CLM-409261 → UHC-47620-31 (Vincent Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004493 | Orphan claim re-pointed Claims processor | CLM-432094 → UHC-16104-34 (Deborah Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004494 | Orphan claim re-pointed Claims processor | CLM-431622 → UHC-76159-37 (Diego Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004495 | Orphan claim re-pointed Claims processor | CLM-420556 → UHC-25750-60 (Mary Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004496 | Orphan claim re-pointed Claims processor | CLM-418527 → UHC-87923-96 (Hiroshi Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004497 | Orphan claim re-pointed Claims processor | CLM-415040 → UHC-50091-64 (Danielle Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004498 | Orphan claim re-pointed Claims processor | CLM-432564 → UHC-58530-01 (Charlotte Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004499 | Orphan claim re-pointed Claims processor | CLM-407099 → UHC-94703-42 (Russell Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004500 | Orphan claim re-pointed Claims processor | CLM-420495 → UHC-08427-65 (Nicole George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004501 | Orphan claim re-pointed Claims processor | CLM-432281 → UHC-24206-61 (Amanda Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004502 | Orphan claim re-pointed Claims processor | CLM-426350 → UHC-32080-45 (Maria Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004503 | Orphan claim re-pointed Claims processor | CLM-423219 → UHC-90276-54 (Rachel Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004504 | Orphan claim re-pointed Claims processor | CLM-408671 → UHC-15119-47 (Willie Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004505 | Orphan claim re-pointed Claims processor | CLM-404770 → UHC-72273-24 (Luis Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004506 | Orphan claim re-pointed Claims processor | CLM-432718 → UHC-30395-04 (William Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004507 | Orphan claim re-pointed Claims processor | CLM-413963 → UHC-04296-62 (Janet Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004508 | Orphan claim re-pointed Claims processor | CLM-419345 → UHC-35804-59 (Gloria Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004509 | Orphan claim re-pointed Claims processor | CLM-427833 → UHC-64643-18 (Arthur Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004510 | Orphan claim re-pointed Claims processor | CLM-404493 → UHC-32520-91 (Jonathan Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004511 | Orphan claim re-pointed Claims processor | CLM-404045 → UHC-24041-45 (Robert Wang) |
| 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.