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-004812 | Orphan claim re-pointed Claims processor | CLM-407451 → UHC-58187-57 (Ann Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004813 | Orphan claim re-pointed Claims processor | CLM-409319 → UHC-44820-99 (Madison Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004814 | Orphan claim re-pointed Claims processor | CLM-417101 → UHC-28356-24 (Susan McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004815 | Orphan claim re-pointed Claims processor | CLM-419038 → UHC-32568-63 (Becky Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004816 | Orphan claim re-pointed Claims processor | CLM-423580 → UHC-99113-47 (Ethan Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004817 | Orphan claim re-pointed Claims processor | CLM-414353 → UHC-04909-22 (Rebecca Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004818 | Orphan claim re-pointed Claims processor | CLM-402138 → UHC-32734-85 (Bruce Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004819 | Orphan claim re-pointed Claims processor | CLM-408434 → UHC-85118-52 (Ryan Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004820 | Orphan claim re-pointed Claims processor | CLM-408840 → UHC-25927-01 (Carolyn Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004821 | Orphan claim re-pointed Claims processor | CLM-412895 → UHC-32595-69 (Gregory Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004822 | Orphan claim re-pointed Claims processor | CLM-418309 → UHC-48557-53 (Emma Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004823 | Orphan claim re-pointed Claims processor | CLM-414302 → UHC-10145-26 (Abigail Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004824 | Orphan claim re-pointed Claims processor | CLM-402123 → UHC-38610-80 (Philip White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004825 | Orphan claim re-pointed Claims processor | CLM-419752 → UHC-73103-71 (Theresa Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004826 | Orphan claim re-pointed Claims processor | CLM-418808 → UHC-25505-58 (Tim Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004827 | Orphan claim re-pointed Claims processor | CLM-421628 → UHC-17607-31 (Mei Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004828 | Orphan claim re-pointed Claims processor | CLM-415064 → UHC-10466-66 (Marilyn Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004829 | Orphan claim re-pointed Claims processor | CLM-412903 → UHC-51193-31 (Barbara Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004830 | Orphan claim re-pointed Claims processor | CLM-402945 → UHC-91801-04 (Frances Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004831 | Orphan claim re-pointed Claims processor | CLM-401315 → UHC-03305-49 (Abigail Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004832 | Orphan claim re-pointed Claims processor | CLM-426477 → UHC-38456-67 (Gregory Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004833 | Orphan claim re-pointed Claims processor | CLM-421560 → UHC-03915-92 (Billy Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004834 | Orphan claim re-pointed Claims processor | CLM-402660 → UHC-07968-99 (Cheryl Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004835 | Orphan claim re-pointed Claims processor | CLM-428101 → UHC-84010-93 (Valentina Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004836 | Orphan claim re-pointed Claims processor | CLM-405006 → UHC-92819-03 (Linda Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004837 | Orphan claim re-pointed Claims processor | CLM-427920 → UHC-68920-96 (Walter Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004838 | Orphan claim re-pointed Claims processor | CLM-430023 → UHC-44962-59 (Mason Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004839 | Orphan claim re-pointed Claims processor | CLM-424715 → UHC-15360-01 (Daniel Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004840 | Orphan claim re-pointed Claims processor | CLM-410286 → UHC-57632-09 (Daniel Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004841 | Orphan claim re-pointed Claims processor | CLM-420698 → UHC-66472-11 (Carolyn Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004842 | Orphan claim re-pointed Claims processor | CLM-418506 → UHC-20425-50 (Emma Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004843 | Orphan claim re-pointed Claims processor | CLM-423931 → UHC-40678-20 (Lori Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004844 | Orphan claim re-pointed Claims processor | CLM-400580 → UHC-82947-39 (William Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004845 | Orphan claim re-pointed Claims processor | CLM-424714 → UHC-15360-01 (Daniel Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004846 | Orphan claim re-pointed Claims processor | CLM-402333 → UHC-92871-62 (Hannah Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004847 | Orphan claim re-pointed Claims processor | CLM-420507 → UHC-34589-55 (Judith Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004848 | Orphan claim re-pointed Claims processor | CLM-421592 → UHC-60624-22 (Bobby Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004849 | Orphan claim re-pointed Claims processor | CLM-430376 → UHC-04065-77 (Smantha Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004850 | Orphan claim re-pointed Claims processor | CLM-415149 → UHC-56477-42 (Marcus Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004851 | Orphan claim re-pointed Claims processor | CLM-415309 → UHC-19255-33 (Brandon Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004852 | Orphan claim re-pointed Claims processor | CLM-422177 → UHC-47758-36 (Austin Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004853 | Orphan claim re-pointed Claims processor | CLM-422767 → UHC-91026-53 (Joe Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004854 | Orphan claim re-pointed Claims processor | CLM-410330 → UHC-74277-24 (Ronald Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004855 | Orphan claim re-pointed Claims processor | CLM-417952 → UHC-06317-61 (Ann Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004856 | Orphan claim re-pointed Claims processor | CLM-422071 → UHC-73850-59 (Gerald Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004857 | Orphan claim re-pointed Claims processor | CLM-418316 → UHC-17288-64 (Joan Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004858 | Orphan claim re-pointed Claims processor | CLM-431819 → UHC-54842-57 (Linda Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004859 | Orphan claim re-pointed Claims processor | CLM-423443 → UHC-77518-93 (Stephen Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004860 | Orphan claim re-pointed Claims processor | CLM-419824 → UHC-24963-18 (Santiago Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004861 | Orphan claim re-pointed Claims processor | CLM-412577 → UHC-43516-61 (Joe Ford) |
| 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.