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-004612 | Orphan claim re-pointed Claims processor | CLM-413772 → UHC-52632-70 (Nathan Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004613 | Orphan claim re-pointed Claims processor | CLM-425000 → UHC-99148-14 (Victoria Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004614 | Orphan claim re-pointed Claims processor | CLM-406943 → UHC-06520-75 (Priya Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004615 | Orphan claim re-pointed Claims processor | CLM-409349 → UHC-57072-21 (Matthew Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004616 | Orphan claim re-pointed Claims processor | CLM-420323 → UHC-57776-26 (Tucker Daniel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004617 | Orphan claim re-pointed Claims processor | CLM-404721 → UHC-99637-20 (Benjamin Morgen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004618 | Orphan claim re-pointed Claims processor | CLM-410599 → UHC-74026-83 (Paul Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004619 | Orphan claim re-pointed Claims processor | CLM-428691 → UHC-92720-51 (Lucia Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004620 | Orphan claim re-pointed Claims processor | CLM-415633 → UHC-94738-12 (Mei Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004621 | Orphan claim re-pointed Claims processor | CLM-411595 → UHC-89738-84 (Amanda Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004622 | Orphan claim re-pointed Claims processor | CLM-405461 → UHC-90340-61 (Jessica Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004623 | Orphan claim re-pointed Claims processor | CLM-419610 → UHC-02605-09 (Logan Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004624 | Orphan claim re-pointed Claims processor | CLM-424760 → UHC-28956-10 (Shirley Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004625 | Orphan claim re-pointed Claims processor | CLM-415682 → UHC-13873-93 (Michelle King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004626 | Orphan claim re-pointed Claims processor | CLM-425162 → UHC-04344-86 (Noah Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004627 | Orphan claim re-pointed Claims processor | CLM-429704 → UHC-09752-86 (Joshua Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004628 | Orphan claim re-pointed Claims processor | CLM-426191 → UHC-89652-89 (Rebecca Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004629 | Orphan claim re-pointed Claims processor | CLM-415380 → UHC-54040-20 (Kyle Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004630 | Orphan claim re-pointed Claims processor | CLM-401564 → UHC-59519-73 (Isabella Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004631 | Orphan claim re-pointed Claims processor | CLM-430389 → UHC-38492-32 (Keith Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004632 | Orphan claim re-pointed Claims processor | CLM-401755 → UHC-09575-01 (Juan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004633 | Orphan claim re-pointed Claims processor | CLM-403308 → UHC-59675-28 (Hannah Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004634 | Orphan claim re-pointed Claims processor | CLM-409974 → UHC-70041-90 (Tyler Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004635 | Orphan claim re-pointed Claims processor | CLM-427307 → UHC-55595-27 (Patricia Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004636 | Orphan claim re-pointed Claims processor | CLM-400039 → UHC-74188-59 (Logan Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004637 | Orphan claim re-pointed Claims processor | CLM-413341 → UHC-87948-44 (Samantha Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004638 | Orphan claim re-pointed Claims processor | CLM-413266 → UHC-19722-01 (Walter Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004639 | Orphan claim re-pointed Claims processor | CLM-423371 → UHC-43310-10 (Deborah Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004640 | Orphan claim re-pointed Claims processor | CLM-422511 → UHC-75523-93 (Joseph Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004641 | Orphan claim re-pointed Claims processor | CLM-415648 → UHC-79616-93 (Arthur Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004642 | Orphan claim re-pointed Claims processor | CLM-414521 → UHC-46817-61 (Mateo Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004643 | Orphan claim re-pointed Claims processor | CLM-418486 → UHC-92698-48 (Martha Haimlton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004644 | Orphan claim re-pointed Claims processor | CLM-408842 → UHC-62451-86 (Berb Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004645 | Orphan claim re-pointed Claims processor | CLM-415807 → UHC-39950-19 (Karen Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004646 | Orphan claim re-pointed Claims processor | CLM-418487 → UHC-29960-66 (Julia Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004647 | Orphan claim re-pointed Claims processor | CLM-412584 → UHC-95902-92 (Richard Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004648 | Orphan claim re-pointed Claims processor | CLM-406572 → UHC-69881-24 (Jean Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004649 | Orphan claim re-pointed Claims processor | CLM-413507 → UHC-05207-17 (Scott Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004650 | Orphan claim re-pointed Claims processor | CLM-431068 → UHC-71496-81 (Aleexander Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004651 | Orphan claim re-pointed Claims processor | CLM-416192 → UHC-72425-74 (Steven Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004652 | Orphan claim re-pointed Claims processor | CLM-401601 → UHC-20395-46 (Michelle Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004653 | Orphan claim re-pointed Claims processor | CLM-410565 → UHC-15160-88 (Sean Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004654 | Orphan claim re-pointed Claims processor | CLM-402140 → UHC-32734-85 (Bruce Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004655 | Orphan claim re-pointed Claims processor | CLM-421164 → UHC-52984-88 (Bradley Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004656 | Orphan claim re-pointed Claims processor | CLM-421849 → UHC-40826-72 (Charles Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004657 | Orphan claim re-pointed Claims processor | CLM-418328 → UHC-29058-11 (Hannah Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004658 | Orphan claim re-pointed Claims processor | CLM-405819 → UHC-02231-81 (Justin Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004659 | Orphan claim re-pointed Claims processor | CLM-410698 → UHC-84467-90 (Brandon Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004660 | Orphan claim re-pointed Claims processor | CLM-408257 → UHC-44075-82 (Wayne Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004661 | Orphan claim re-pointed Claims processor | CLM-420320 → UHC-80809-16 (Isabella Garza) |
| 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.