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-004712 | Orphan claim re-pointed Claims processor | CLM-400960 → UHC-15651-83 (Patricia Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004713 | Orphan claim re-pointed Claims processor | CLM-411167 → UHC-74741-25 (Jose Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004714 | Orphan claim re-pointed Claims processor | CLM-421648 → UHC-54160-30 (Aaron Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004715 | Orphan claim re-pointed Claims processor | CLM-420220 → UHC-19964-20 (Ruth Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004716 | Orphan claim re-pointed Claims processor | CLM-409864 → UHC-32255-61 (Nicole Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004717 | Orphan claim re-pointed Claims processor | CLM-430242 → UHC-60706-35 (Adam Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004718 | Orphan claim re-pointed Claims processor | CLM-414235 → UHC-45897-76 (Lori Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004719 | Orphan claim re-pointed Claims processor | CLM-401466 → UHC-10719-99 (Barbara Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004720 | Orphan claim re-pointed Claims processor | CLM-417017 → UHC-45212-97 (Christina Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004721 | Orphan claim re-pointed Claims processor | CLM-412877 → UHC-84136-34 (Melissa Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004722 | Orphan claim re-pointed Claims processor | CLM-416061 → UHC-95205-05 (Donald Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004723 | Orphan claim re-pointed Claims processor | CLM-404646 → UHC-53091-93 (Angela Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004724 | Orphan claim re-pointed Claims processor | CLM-428162 → UHC-30097-39 (Shirley Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004725 | Orphan claim re-pointed Claims processor | CLM-416656 → UHC-21051-13 (Judith Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004726 | Orphan claim re-pointed Claims processor | CLM-410949 → UHC-39292-35 (Lawrence Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004727 | Orphan claim re-pointed Claims processor | CLM-406848 → UHC-12071-84 (Abby Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004728 | Orphan claim re-pointed Claims processor | CLM-408787 → UHC-51039-01 (Jacob Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004729 | Orphan claim re-pointed Claims processor | CLM-430316 → UHC-74911-42 (Ethan Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004730 | Orphan claim re-pointed Claims processor | CLM-424235 → UHC-05960-06 (Kayla Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004731 | Orphan claim re-pointed Claims processor | CLM-415947 → UHC-50761-37 (Jean Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004732 | Orphan claim re-pointed Claims processor | CLM-426745 → UHC-40588-93 (Brenda Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004733 | Orphan claim re-pointed Claims processor | CLM-424664 → UHC-60560-81 (Alice Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004734 | Orphan claim re-pointed Claims processor | CLM-421452 → UHC-36480-49 (Ralph Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004735 | Orphan claim re-pointed Claims processor | CLM-416265 → UHC-41663-21 (Jonathan Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004736 | Orphan claim re-pointed Claims processor | CLM-402887 → UHC-08276-88 (Mark Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004737 | Orphan claim re-pointed Claims processor | CLM-413957 → UHC-69678-10 (Luis Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004738 | Orphan claim re-pointed Claims processor | CLM-425157 → UHC-72647-57 (Sara Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004739 | Orphan claim re-pointed Claims processor | CLM-428777 → UHC-57440-22 (Jacob Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004740 | Orphan claim re-pointed Claims processor | CLM-420950 → UHC-28875-07 (Hiroshi Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004741 | Orphan claim re-pointed Claims processor | CLM-414775 → UHC-96890-16 (Carol Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004742 | Orphan claim re-pointed Claims processor | CLM-425773 → UHC-21911-64 (Joan Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004743 | Orphan claim re-pointed Claims processor | CLM-418039 → UHC-23021-94 (Sofia Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004744 | Orphan claim re-pointed Claims processor | CLM-432798 → UHC-04979-01 (Albert Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004745 | Orphan claim re-pointed Claims processor | CLM-420823 → UHC-90013-58 (Logan Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004746 | Orphan claim re-pointed Claims processor | CLM-404949 → UHC-22461-47 (Nicole Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004747 | Orphan claim re-pointed Claims processor | CLM-414439 → UHC-47895-75 (Teresa Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004748 | Orphan claim re-pointed Claims processor | CLM-426344 → UHC-71491-85 (Omar Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004749 | Orphan claim re-pointed Claims processor | CLM-410916 → UHC-81632-20 (Teresa Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004750 | Orphan claim re-pointed Claims processor | CLM-401598 → UHC-21240-90 (Brandon Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004751 | Orphan claim re-pointed Claims processor | CLM-422144 → UHC-88614-34 (Joan Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004752 | Orphan claim re-pointed Claims processor | CLM-402279 → UHC-73386-28 (Vincent Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004753 | Orphan claim re-pointed Claims processor | CLM-407997 → UHC-20499-93 (Angela Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004754 | Orphan claim re-pointed Claims processor | CLM-413007 → UHC-76555-39 (Camila Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004755 | Orphan claim re-pointed Claims processor | CLM-400947 → UHC-10546-53 (Amy Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004756 | Orphan claim re-pointed Claims processor | CLM-420974 → UHC-83917-22 (Angela Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004757 | Orphan claim re-pointed Claims processor | CLM-419867 → UHC-54865-20 (Sanitago Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004758 | Orphan claim re-pointed Claims processor | CLM-408688 → UHC-77500-44 (Evelyn Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004759 | Orphan claim re-pointed Claims processor | CLM-431638 → UHC-72009-07 (Melissa Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004760 | Orphan claim re-pointed Claims processor | CLM-403641 → UHC-74959-06 (Wells Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004761 | Orphan claim re-pointed Claims processor | CLM-411098 → UHC-90440-20 (Roger Robertson) |
| 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.