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-002440 | Orphan claim re-pointed Claims processor | CLM-419022 → UHC-01306-79 (Katherine Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002441 | Orphan claim re-pointed Claims processor | CLM-430784 → UHC-48702-23 (Catherine Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002442 | Orphan claim re-pointed Claims processor | CLM-429290 → UHC-96611-25 (Virginia Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002443 | Orphan claim re-pointed Claims processor | CLM-420313 → UHC-05181-14 (Gregory Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002444 | Orphan claim re-pointed Claims processor | CLM-420775 → UHC-65981-16 (Carol Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002445 | Orphan claim re-pointed Claims processor | CLM-425868 → UHC-04795-68 (Bobby Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002446 | Orphan claim re-pointed Claims processor | CLM-431797 → UHC-22691-20 (Catherine Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002447 | Orphan claim re-pointed Claims processor | CLM-420526 → UHC-53502-65 (George Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002448 | Orphan claim re-pointed Claims processor | CLM-402898 → UHC-27015-08 (Wayne Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002449 | Orphan claim re-pointed Claims processor | CLM-425930 → UHC-45484-10 (Daaniel Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002450 | Orphan claim re-pointed Claims processor | CLM-416362 → UHC-86273-40 (Bradley Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002451 | Orphan claim re-pointed Claims processor | CLM-403232 → UHC-57532-56 (Raymond Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002452 | Orphan claim re-pointed Claims processor | CLM-409414 → UHC-24069-93 (Bobby Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002453 | Orphan claim re-pointed Claims processor | CLM-422613 → UHC-61358-72 (Carlos Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002454 | Orphan claim re-pointed Claims processor | CLM-419859 → UHC-32095-94 (Julie Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002455 | Orphan claim re-pointed Claims processor | CLM-424888 → UHC-11310-74 (Dennis Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002456 | Orphan claim re-pointed Claims processor | CLM-424109 → UHC-22742-24 (Omar Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002457 | Orphan claim re-pointed Claims processor | CLM-431888 → UHC-07580-34 (Diego Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002458 | Orphan claim re-pointed Claims processor | CLM-408931 → UHC-92591-12 (Kevin Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002459 | Orphan claim re-pointed Claims processor | CLM-421878 → UHC-29411-66 (Maria Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002460 | Orphan claim re-pointed Claims processor | CLM-400042 → UHC-28042-53 (Eric James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002461 | Orphan claim re-pointed Claims processor | CLM-421023 → UHC-52595-90 (Justin Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002462 | Orphan claim re-pointed Claims processor | CLM-419794 → UHC-32104-52 (Patricia Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002463 | Orphan claim re-pointed Claims processor | CLM-406797 → UHC-46929-19 (Doris Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002464 | Orphan claim re-pointed Claims processor | CLM-419840 → UHC-08156-10 (Nicole Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002465 | Orphan claim re-pointed Claims processor | CLM-404228 → UHC-09367-68 (Willie Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002466 | Orphan claim re-pointed Claims processor | CLM-409809 → UHC-50412-25 (Albert Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002467 | Orphan claim re-pointed Claims processor | CLM-416653 → UHC-50198-86 (Roy Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002468 | Orphan claim re-pointed Claims processor | CLM-405649 → UHC-31945-76 (John Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002469 | Orphan claim re-pointed Claims processor | CLM-409329 → UHC-60651-71 (Charlotte Nunze) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002470 | Orphan claim re-pointed Claims processor | CLM-418179 → UHC-88894-40 (Gregory Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002471 | Orphan claim re-pointed Claims processor | CLM-409411 → UHC-89150-20 (Kathleen Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002472 | Orphan claim re-pointed Claims processor | CLM-432518 → UHC-90246-63 (Joe Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002473 | Orphan claim re-pointed Claims processor | CLM-400559 → UHC-22304-73 (Mateo Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002474 | Orphan claim re-pointed Claims processor | CLM-414384 → UHC-96845-13 (Douglas Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002475 | Orphan claim re-pointed Claims processor | CLM-419351 → UHC-54757-66 (Marilyn Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002476 | Orphan claim re-pointed Claims processor | CLM-410405 → UHC-06521-05 (Deborah Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002477 | Orphan claim re-pointed Claims processor | CLM-405186 → UHC-13167-79 (Yuki Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002478 | Orphan claim re-pointed Claims processor | CLM-413660 → UHC-64552-91 (Danny Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002479 | Orphan claim re-pointed Claims processor | CLM-419655 → UHC-70900-77 (Samuel Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002480 | Orphan claim re-pointed Claims processor | CLM-409065 → UHC-91935-85 (Kenneth Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002481 | Orphan claim re-pointed Claims processor | CLM-406315 → UHC-67432-85 (Santiago Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002482 | Orphan claim re-pointed Claims processor | CLM-420704 → UHC-89743-30 (Juan Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002483 | Orphan claim re-pointed Claims processor | CLM-403740 → UHC-15167-50 (Gerald Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002484 | Orphan claim re-pointed Claims processor | CLM-418627 → UHC-05969-13 (John Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002485 | Orphan claim re-pointed Claims processor | CLM-415741 → UHC-13181-99 (Jonathan Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002486 | Orphan claim re-pointed Claims processor | CLM-409643 → UHC-10049-27 (Gerald Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002487 | Orphan claim re-pointed Claims processor | CLM-427084 → UHC-21658-64 (Sarah Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002488 | Orphan claim re-pointed Claims processor | CLM-408303 → UHC-16363-55 (Kayla Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002489 | Orphan claim re-pointed Claims processor | CLM-410745 → UHC-39122-29 (Joan Vega) |
| 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.