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-004562 | Orphan claim re-pointed Claims processor | CLM-410906 → UHC-73708-61 (Laura Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004563 | Orphan claim re-pointed Claims processor | CLM-422761 → UHC-40438-30 (Paul King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004564 | Orphan claim re-pointed Claims processor | CLM-412318 → UHC-80658-32 (John Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004565 | Orphan claim re-pointed Claims processor | CLM-419485 → UHC-27593-40 (Gerald Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004566 | Orphan claim re-pointed Claims processor | CLM-402811 → UHC-52239-76 (Brandon Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004567 | Orphan claim re-pointed Claims processor | CLM-400709 → UHC-35819-35 (Jacob Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004568 | Orphan claim re-pointed Claims processor | CLM-406227 → UHC-83109-91 (Nicholas Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004569 | Orphan claim re-pointed Claims processor | CLM-415074 → UHC-31919-96 (Sarah Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004570 | Orphan claim re-pointed Claims processor | CLM-412293 → UHC-18381-60 (Matthew Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004571 | Orphan claim re-pointed Claims processor | CLM-406929 → UHC-06351-52 (Sanitago Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004572 | Orphan claim re-pointed Claims processor | CLM-403242 → UHC-21738-50 (Keith Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004573 | Orphan claim re-pointed Claims processor | CLM-425766 → UHC-00616-73 (Anthony Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004574 | Orphan claim re-pointed Claims processor | CLM-430807 → UHC-35070-76 (Ryan Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004575 | Orphan claim re-pointed Claims processor | CLM-415009 → UHC-06230-57 (Sofia Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004576 | Orphan claim re-pointed Claims processor | CLM-401351 → UHC-13237-39 (Carolyn Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004577 | Orphan claim re-pointed Claims processor | CLM-425726 → UHC-06763-58 (Matthew Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004578 | Orphan claim re-pointed Claims processor | CLM-410847 → UHC-08618-64 (Carolyn Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004579 | Orphan claim re-pointed Claims processor | CLM-425018 → UHC-70793-11 (Alan Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004580 | Orphan claim re-pointed Claims processor | CLM-427363 → UHC-85220-86 (Peter Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004581 | Orphan claim re-pointed Claims processor | CLM-401585 → UHC-95759-83 (Wayne Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004582 | Orphan claim re-pointed Claims processor | CLM-424255 → UHC-38641-40 (Scott Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004583 | Orphan claim re-pointed Claims processor | CLM-428010 → UHC-52094-05 (Michael Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004584 | Orphan claim re-pointed Claims processor | CLM-412098 → UHC-38723-32 (Abigail Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004585 | Orphan claim re-pointed Claims processor | CLM-404580 → UHC-65469-13 (Melissa Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004586 | Orphan claim re-pointed Claims processor | CLM-407399 → UHC-37090-99 (Pamela Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004587 | Orphan claim re-pointed Claims processor | CLM-402768 → UHC-82117-14 (Gloria Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004588 | Orphan claim re-pointed Claims processor | CLM-415600 → UHC-70821-83 (Aisha Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004589 | Orphan claim re-pointed Claims processor | CLM-432768 → UHC-11191-55 (Margaret Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004590 | Orphan claim re-pointed Claims processor | CLM-401052 → UHC-19364-47 (Rebecca Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004591 | Orphan claim re-pointed Claims processor | CLM-404914 → UHC-52819-86 (Austin Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004592 | Orphan claim re-pointed Claims processor | CLM-408913 → UHC-09600-88 (Theresa Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004593 | Orphan claim re-pointed Claims processor | CLM-402260 → UHC-39153-49 (Susan Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004594 | Orphan claim re-pointed Claims processor | CLM-423873 → UHC-26130-42 (Jennifer Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004595 | Orphan claim re-pointed Claims processor | CLM-412103 → UHC-25245-14 (Lawrence Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004596 | Orphan claim re-pointed Claims processor | CLM-405570 → UHC-86814-03 (Judy Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004597 | Orphan claim re-pointed Claims processor | CLM-400050 → UHC-53605-63 (Brenda Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004598 | Orphan claim re-pointed Claims processor | CLM-412277 → UHC-22875-45 (Catherine Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004599 | Orphan claim re-pointed Claims processor | CLM-415475 → UHC-91957-14 (Frank Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004600 | Orphan claim re-pointed Claims processor | CLM-416517 → UHC-15332-76 (Christian Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004601 | Orphan claim re-pointed Claims processor | CLM-425628 → UHC-57723-18 (Luis Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004602 | Orphan claim re-pointed Claims processor | CLM-415918 → UHC-84155-80 (Karen Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004603 | Orphan claim re-pointed Claims processor | CLM-415786 → UHC-34349-59 (Ana Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004604 | Orphan claim re-pointed Claims processor | CLM-424395 → UHC-96841-08 (Donna Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004605 | Orphan claim re-pointed Claims processor | CLM-430099 → UHC-33373-43 (Nathan Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004606 | Orphan claim re-pointed Claims processor | CLM-426616 → UHC-42035-49 (Beverly Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004607 | Orphan claim re-pointed Claims processor | CLM-423989 → UHC-28027-27 (Randy Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004608 | Orphan claim re-pointed Claims processor | CLM-420310 → UHC-74147-24 (Sophia Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004609 | Orphan claim re-pointed Claims processor | CLM-411785 → UHC-19640-97 (Arjun Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004610 | Orphan claim re-pointed Claims processor | CLM-432299 → UHC-26938-12 (Laura Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004611 | Orphan claim re-pointed Claims processor | CLM-417515 → UHC-36962-36 (Gloria Simpson) |
| 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.