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-004912 | Orphan claim re-pointed Claims processor | CLM-428671 → UHC-09579-56 (Jordan Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004913 | Orphan claim re-pointed Claims processor | CLM-408935 → UHC-64855-03 (William Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004914 | Orphan claim re-pointed Claims processor | CLM-411817 → UHC-21040-87 (Jason Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004915 | Orphan claim re-pointed Claims processor | CLM-401495 → UHC-62841-33 (Andrea Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004916 | Orphan claim re-pointed Claims processor | CLM-424442 → UHC-54477-49 (Lawrence Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004917 | Orphan claim re-pointed Claims processor | CLM-417025 → UHC-33520-63 (Gerald Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004918 | Orphan claim re-pointed Claims processor | CLM-411979 → UHC-54967-01 (Hiroshi Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004919 | Orphan claim re-pointed Claims processor | CLM-418623 → UHC-43015-79 (Scott Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004920 | Orphan claim re-pointed Claims processor | CLM-414312 → UHC-10286-01 (Stephanie Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004921 | Orphan claim re-pointed Claims processor | CLM-426867 → UHC-86485-66 (Andrea Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004922 | Orphan claim re-pointed Claims processor | CLM-414094 → UHC-29655-41 (Debra Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004923 | Orphan claim re-pointed Claims processor | CLM-429045 → UHC-63180-30 (Kyle Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004924 | Orphan claim re-pointed Claims processor | CLM-410861 → UHC-27719-91 (Rachel Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004925 | Orphan claim re-pointed Claims processor | CLM-428841 → UHC-53711-81 (Samantha Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004926 | Orphan claim re-pointed Claims processor | CLM-423547 → UHC-57608-82 (Scott Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004927 | Orphan claim re-pointed Claims processor | CLM-403193 → UHC-30665-98 (Alice Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004928 | Orphan claim re-pointed Claims processor | CLM-414853 → UHC-05029-61 (Peter Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004929 | Orphan claim re-pointed Claims processor | CLM-417363 → UHC-08070-07 (Marcus Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004930 | Orphan claim re-pointed Claims processor | CLM-403050 → UHC-36033-31 (Ethan Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004931 | Orphan claim re-pointed Claims processor | CLM-408593 → UHC-19554-84 (Steven Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004932 | Orphan claim re-pointed Claims processor | CLM-404175 → UHC-51717-16 (Willie Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004933 | Orphan claim re-pointed Claims processor | CLM-401678 → UHC-09755-63 (Nicole Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004934 | Orphan claim re-pointed Claims processor | CLM-415506 → UHC-91983-24 (Debra Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004935 | Orphan claim re-pointed Claims processor | CLM-429053 → UHC-45256-12 (Christian Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004936 | Orphan claim re-pointed Claims processor | CLM-406378 → UHC-20647-47 (Mark Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004937 | Orphan claim re-pointed Claims processor | CLM-414129 → UHC-86614-46 (Gary Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004938 | Orphan claim re-pointed Claims processor | CLM-403670 → UHC-71464-18 (Lawrence Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004939 | Orphan claim re-pointed Claims processor | CLM-401204 → UHC-20620-59 (Katherine Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004940 | Orphan claim re-pointed Claims processor | CLM-410679 → UHC-70285-55 (Bobby Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004941 | Orphan claim re-pointed Claims processor | CLM-419486 → UHC-05981-64 (Raymond Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004942 | Orphan claim re-pointed Claims processor | CLM-409625 → UHC-38082-71 (Ann Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004943 | Orphan claim re-pointed Claims processor | CLM-409123 → UHC-77399-76 (Logan Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004944 | Orphan claim re-pointed Claims processor | CLM-428768 → UHC-21688-31 (Kyle Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004945 | Orphan claim re-pointed Claims processor | CLM-413104 → UHC-02443-02 (Lori Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004946 | Orphan claim re-pointed Claims processor | CLM-407465 → UHC-39735-08 (Barbara Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004947 | Orphan claim re-pointed Claims processor | CLM-417155 → UHC-31823-84 (Rachel Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004948 | Orphan claim re-pointed Claims processor | CLM-427104 → UHC-84726-80 (Lori Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004949 | Orphan claim re-pointed Claims processor | CLM-426177 → UHC-22708-92 (Jose Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004950 | Orphan claim re-pointed Claims processor | CLM-408613 → UHC-65445-38 (Matthew Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004951 | Orphan claim re-pointed Claims processor | CLM-425952 → UHC-93558-25 (Jennier Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004952 | Orphan claim re-pointed Claims processor | CLM-424800 → UHC-11375-71 (Keith Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004953 | Orphan claim re-pointed Claims processor | CLM-411548 → UHC-94243-99 (Martha Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004954 | Orphan claim re-pointed Claims processor | CLM-406216 → UHC-20565-29 (Lauren Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004955 | Orphan claim re-pointed Claims processor | CLM-408032 → UHC-18542-99 (Deborah Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004956 | Orphan claim re-pointed Claims processor | CLM-418572 → UHC-21529-84 (Danielle Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004957 | Orphan claim re-pointed Claims processor | CLM-413887 → UHC-89891-19 (Carol Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004958 | Orphan claim re-pointed Claims processor | CLM-400466 → UHC-08752-97 (Wayne Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004959 | Orphan claim re-pointed Claims processor | CLM-431290 → UHC-61154-15 (Roy Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004960 | Orphan claim re-pointed Claims processor | CLM-401059 → UHC-17944-90 (Charles Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004961 | Orphan claim re-pointed Claims processor | CLM-403395 → UHC-66248-58 (Ahmed Ferguson) |
| 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.