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-004862 | Orphan claim re-pointed Claims processor | CLM-409851 → UHC-99350-16 (Denise Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004863 | Orphan claim re-pointed Claims processor | CLM-407279 → UHC-25477-01 (Nathan Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004864 | Orphan claim re-pointed Claims processor | CLM-409390 → UHC-56406-57 (Jonathan Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004865 | Orphan claim re-pointed Claims processor | CLM-416095 → UHC-12370-45 (Sandra Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004866 | Orphan claim re-pointed Claims processor | CLM-431166 → UHC-25672-92 (Elizabeth Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004867 | Orphan claim re-pointed Claims processor | CLM-402607 → UHC-70632-75 (Gerald Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004868 | Orphan claim re-pointed Claims processor | CLM-413749 → UHC-93422-08 (Gregory Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004869 | Orphan claim re-pointed Claims processor | CLM-412648 → UHC-69097-81 (Janet Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004870 | Orphan claim re-pointed Claims processor | CLM-426660 → UHC-67515-75 (Debra Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004871 | Orphan claim re-pointed Claims processor | CLM-414087 → UHC-63894-92 (Tyler Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004872 | Orphan claim re-pointed Claims processor | CLM-422632 → UHC-13473-34 (Heather Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004873 | Orphan claim re-pointed Claims processor | CLM-409902 → UHC-70834-58 (Kevin Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004874 | Orphan claim re-pointed Claims processor | CLM-417338 → UHC-14545-99 (Jerry Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004875 | Orphan claim re-pointed Claims processor | CLM-405690 → UHC-73022-03 (Ruth Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004876 | Orphan claim re-pointed Claims processor | CLM-420948 → UHC-52531-44 (Jason Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004877 | Orphan claim re-pointed Claims processor | CLM-403224 → UHC-94863-84 (Michael Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004878 | Orphan claim re-pointed Claims processor | CLM-415128 → UHC-47059-01 (Natalie Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004879 | Orphan claim re-pointed Claims processor | CLM-412651 → UHC-37643-23 (Evelyn Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004880 | Orphan claim re-pointed Claims processor | CLM-409668 → UHC-50547-71 (Barb Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004881 | Orphan claim re-pointed Claims processor | CLM-422428 → UHC-60111-01 (Doris Frod) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004882 | Orphan claim re-pointed Claims processor | CLM-431397 → UHC-69637-54 (Jesse Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004883 | Orphan claim re-pointed Claims processor | CLM-420132 → UHC-58560-58 (Lawrence Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004884 | Orphan claim re-pointed Claims processor | CLM-423846 → UHC-35977-69 (Anna Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004885 | Orphan claim re-pointed Claims processor | CLM-410649 → UHC-75411-44 (Hiroshi Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004886 | Orphan claim re-pointed Claims processor | CLM-430618 → UHC-38405-46 (Peter Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004887 | Orphan claim re-pointed Claims processor | CLM-421841 → UHC-79864-92 (Philip Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004888 | Orphan claim re-pointed Claims processor | CLM-412320 → UHC-51105-44 (Diana Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004889 | Orphan claim re-pointed Claims processor | CLM-428208 → UHC-11771-53 (Abby Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004890 | Orphan claim re-pointed Claims processor | CLM-410149 → UHC-40867-57 (Alexis Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004891 | Orphan claim re-pointed Claims processor | CLM-411208 → UHC-74793-23 (Rebecca Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004892 | Orphan claim re-pointed Claims processor | CLM-410777 → UHC-21935-35 (William Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004893 | Orphan claim re-pointed Claims processor | CLM-423980 → UHC-34607-27 (Jerry Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004894 | Orphan claim re-pointed Claims processor | CLM-430253 → UHC-51174-59 (Shirley Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004895 | Orphan claim re-pointed Claims processor | CLM-416090 → UHC-38994-50 (Charlotte Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004896 | Orphan claim re-pointed Claims processor | CLM-412226 → UHC-54651-03 (Megan Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004897 | Orphan claim re-pointed Claims processor | CLM-409599 → UHC-20571-53 (Debra Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004898 | Orphan claim re-pointed Claims processor | CLM-402932 → UHC-18430-46 (Sarah Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004899 | Orphan claim re-pointed Claims processor | CLM-401600 → UHC-20395-46 (Michelle Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004900 | Orphan claim re-pointed Claims processor | CLM-422084 → UHC-27486-99 (Joyce Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004901 | Orphan claim re-pointed Claims processor | CLM-418339 → UHC-95701-02 (Aaron Torrees) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004902 | Orphan claim re-pointed Claims processor | CLM-407654 → UHC-94336-44 (Emma Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004903 | Orphan claim re-pointed Claims processor | CLM-414304 → UHC-60314-10 (Kathleen Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004904 | Orphan claim re-pointed Claims processor | CLM-416944 → UHC-53088-33 (Dorothy Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004905 | Orphan claim re-pointed Claims processor | CLM-412981 → UHC-21666-89 (Michelle Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004906 | Orphan claim re-pointed Claims processor | CLM-413510 → UHC-89221-28 (William Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004907 | Orphan claim re-pointed Claims processor | CLM-409317 → UHC-23496-10 (Julie Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004908 | Orphan claim re-pointed Claims processor | CLM-432265 → UHC-98452-35 (Martha Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004909 | Orphan claim re-pointed Claims processor | CLM-429623 → UHC-47247-36 (Ronald Vadez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004910 | Orphan claim re-pointed Claims processor | CLM-402440 → UHC-44943-14 (Christine Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004911 | Orphan claim re-pointed Claims processor | CLM-416079 → UHC-80041-28 (Angela Bailey) |
| 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.