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-004512 | Orphan claim re-pointed Claims processor | CLM-432262 → UHC-71373-79 (Julie Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004513 | Orphan claim re-pointed Claims processor | CLM-426631 → UHC-62320-38 (Barbara Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004514 | Orphan claim re-pointed Claims processor | CLM-425929 → UHC-97533-26 (Stephanie Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004515 | Orphan claim re-pointed Claims processor | CLM-406291 → UHC-58381-41 (Nathan Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004516 | Orphan claim re-pointed Claims processor | CLM-405951 → UHC-04052-21 (Carlos Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004517 | Orphan claim re-pointed Claims processor | CLM-409551 → UHC-12877-21 (Angela Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004518 | Orphan claim re-pointed Claims processor | CLM-421851 → UHC-58673-86 (Eugene Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004519 | Orphan claim re-pointed Claims processor | CLM-405105 → UHC-64703-56 (Mary Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004520 | Orphan claim re-pointed Claims processor | CLM-427123 → UHC-50178-70 (Jeremy Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004521 | Orphan claim re-pointed Claims processor | CLM-431550 → UHC-73170-37 (Rebecca Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004522 | Orphan claim re-pointed Claims processor | CLM-405269 → UHC-03948-12 (Russell Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004523 | Orphan claim re-pointed Claims processor | CLM-410028 → UHC-19618-72 (William Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004524 | Orphan claim re-pointed Claims processor | CLM-421634 → UHC-14195-85 (Justin Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004525 | Orphan claim re-pointed Claims processor | CLM-427752 → UHC-53110-13 (Andrea Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004526 | Orphan claim re-pointed Claims processor | CLM-424956 → UHC-13803-78 (Victoria Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004527 | Orphan claim re-pointed Claims processor | CLM-418319 → UHC-92115-80 (Keith Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004528 | Orphan claim re-pointed Claims processor | CLM-421499 → UHC-42424-16 (William Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004529 | Orphan claim re-pointed Claims processor | CLM-432111 → UHC-72592-06 (Patricia Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004530 | Orphan claim re-pointed Claims processor | CLM-414670 → UHC-04246-79 (Brenda Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004531 | Orphan claim re-pointed Claims processor | CLM-431169 → UHC-33427-48 (Theresa Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004532 | Orphan claim re-pointed Claims processor | CLM-420996 → UHC-50500-21 (Ruth Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004533 | Orphan claim re-pointed Claims processor | CLM-409640 → UHC-26483-10 (Willie Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004534 | Orphan claim re-pointed Claims processor | CLM-432277 → UHC-32126-41 (Teresa Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004535 | Orphan claim re-pointed Claims processor | CLM-430654 → UHC-43501-97 (Sandra McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004536 | Orphan claim re-pointed Claims processor | CLM-426574 → UHC-37536-81 (Joyce Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004537 | Orphan claim re-pointed Claims processor | CLM-420476 → UHC-17347-36 (Carl Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004538 | Orphan claim re-pointed Claims processor | CLM-402815 → UHC-47186-94 (Victoria Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004539 | Orphan claim re-pointed Claims processor | CLM-420348 → UHC-70497-07 (Evelyn Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004540 | Orphan claim re-pointed Claims processor | CLM-430525 → UHC-78713-50 (Grace Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004541 | Orphan claim re-pointed Claims processor | CLM-428306 → UHC-63351-43 (Jerry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004542 | Orphan claim re-pointed Claims processor | CLM-414191 → UHC-98991-98 (Ambber Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004543 | Orphan claim re-pointed Claims processor | CLM-429814 → UHC-06078-43 (Joseph Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004544 | Orphan claim re-pointed Claims processor | CLM-420364 → UHC-23204-76 (Ashley Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004545 | Orphan claim re-pointed Claims processor | CLM-411453 → UHC-61918-98 (Ethan Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004546 | Orphan claim re-pointed Claims processor | CLM-419767 → UHC-95770-57 (Chris Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004547 | Orphan claim re-pointed Claims processor | CLM-410574 → UHC-91658-38 (Margaret Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004548 | Orphan claim re-pointed Claims processor | CLM-429447 → UHC-39801-46 (Richard Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004549 | Orphan claim re-pointed Claims processor | CLM-404799 → UHC-68046-13 (Jason Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004550 | Orphan claim re-pointed Claims processor | CLM-417555 → UHC-25544-03 (Billy Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004551 | Orphan claim re-pointed Claims processor | CLM-422953 → UHC-74442-37 (Nancy Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004552 | Orphan claim re-pointed Claims processor | CLM-423492 → UHC-59530-27 (Gabriel Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004553 | Orphan claim re-pointed Claims processor | CLM-424732 → UHC-17116-81 (Joseph Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004554 | Orphan claim re-pointed Claims processor | CLM-416628 → UHC-44112-92 (Gonzales Diana) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004555 | Orphan claim re-pointed Claims processor | CLM-419346 → UHC-62694-54 (Carlos Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004556 | Orphan claim re-pointed Claims processor | CLM-415472 → UHC-71500-43 (James Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004557 | Orphan claim re-pointed Claims processor | CLM-431787 → UHC-67143-84 (Philip Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004558 | Orphan claim re-pointed Claims processor | CLM-427083 → UHC-17770-72 (Anna Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004559 | Orphan claim re-pointed Claims processor | CLM-402107 → UHC-60711-64 (Charlotte Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004560 | Orphan claim re-pointed Claims processor | CLM-420325 → UHC-93718-40 (Lawrence Nichhols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004561 | Orphan claim re-pointed Claims processor | CLM-423688 → UHC-30422-67 (Aaron Johnson) |
| 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.