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-004962 | Orphan claim re-pointed Claims processor | CLM-426348 → UHC-40687-94 (Aaron Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004963 | Orphan claim re-pointed Claims processor | CLM-416422 → UHC-13274-63 (Roger Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004964 | Orphan claim re-pointed Claims processor | CLM-414376 → UHC-68756-92 (Amber Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004965 | Orphan claim re-pointed Claims processor | CLM-403418 → UHC-44424-97 (Bruce Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004966 | Orphan claim re-pointed Claims processor | CLM-403627 → UHC-26683-20 (Edward Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004967 | Orphan claim re-pointed Claims processor | CLM-427007 → UHC-49778-06 (Adam Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004968 | Orphan claim re-pointed Claims processor | CLM-414739 → UHC-52659-90 (Sandra Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004969 | Orphan claim re-pointed Claims processor | CLM-430718 → UHC-02982-66 (Amanda Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004970 | Orphan claim re-pointed Claims processor | CLM-410029 → UHC-19618-72 (William Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004971 | Orphan claim re-pointed Claims processor | CLM-407150 → UHC-38319-19 (Hannah Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004972 | Orphan claim re-pointed Claims processor | CLM-422300 → UHC-28465-51 (Kimberly Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004973 | Orphan claim re-pointed Claims processor | CLM-410336 → UHC-09689-71 (Jake Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004974 | Orphan claim re-pointed Claims processor | CLM-429583 → UHC-47902-51 (Victoria Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004975 | Orphan claim re-pointed Claims processor | CLM-407846 → UHC-60044-90 (Bobby Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004976 | Orphan claim re-pointed Claims processor | CLM-424743 → UHC-06546-55 (Christine Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004977 | Orphan claim re-pointed Claims processor | CLM-425677 → UHC-15231-85 (Bryan Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004978 | Orphan claim re-pointed Claims processor | CLM-417373 → UHC-72664-23 (Jessica Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004979 | Orphan claim re-pointed Claims processor | CLM-409782 → UHC-36165-09 (Mei Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004980 | Orphan claim re-pointed Claims processor | CLM-428216 → UHC-26416-03 (Rebecca Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004981 | Orphan claim re-pointed Claims processor | CLM-432495 → UHC-20991-85 (Cheryl Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004982 | Orphan claim re-pointed Claims processor | CLM-430419 → UHC-29993-99 (Diane Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004983 | Orphan claim re-pointed Claims processor | CLM-407781 → UHC-71023-24 (William Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004984 | Orphan claim re-pointed Claims processor | CLM-419679 → UHC-16262-32 (Abigail Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004985 | Orphan claim re-pointed Claims processor | CLM-402520 → UHC-20227-50 (Douglas Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004986 | Orphan claim re-pointed Claims processor | CLM-411236 → UHC-24705-10 (Billy Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004987 | Orphan claim re-pointed Claims processor | CLM-404854 → UHC-35998-11 (Carolyn Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004988 | Orphan claim re-pointed Claims processor | CLM-410044 → UHC-92857-60 (Sean Sean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004989 | Orphan claim re-pointed Claims processor | CLM-424008 → UHC-55114-04 (Brenda Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004990 | Orphan claim re-pointed Claims processor | CLM-409063 → UHC-15058-92 (Gloria Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004991 | Orphan claim re-pointed Claims processor | CLM-408091 → UHC-11947-28 (Hiroshi Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004992 | Orphan claim re-pointed Claims processor | CLM-410576 → UHC-06958-21 (Larry Sanhez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004993 | Orphan claim re-pointed Claims processor | CLM-404822 → UHC-61173-72 (Michelle Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004994 | Orphan claim re-pointed Claims processor | CLM-404567 → UHC-54937-30 (Grace Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004995 | Orphan claim re-pointed Claims processor | CLM-402267 → UHC-87849-68 (Camila Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004996 | Orphan claim re-pointed Claims processor | CLM-426281 → UHC-83107-81 (Nathan Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004997 | Orphan claim re-pointed Claims processor | CLM-401788 → UHC-47261-99 (Amanda Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004998 | Orphan claim re-pointed Claims processor | CLM-403825 → UHC-40594-68 (Scott Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004999 | Orphan claim re-pointed Claims processor | CLM-415578 → UHC-47268-78 (Mark Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005000 | Orphan claim re-pointed Claims processor | CLM-404482 → UHC-68748-96 (Maria Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005001 | Orphan claim re-pointed Claims processor | CLM-401625 → UHC-99873-07 (Abigail Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005002 | Orphan claim re-pointed Claims processor | CLM-431418 → UHC-90045-65 (Joan Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005003 | Orphan claim re-pointed Claims processor | CLM-431860 → UHC-62190-94 (Randy Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005004 | Orphan claim re-pointed Claims processor | CLM-426199 → UHC-20056-04 (Cheryl Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005005 | Orphan claim re-pointed Claims processor | CLM-425256 → UHC-36645-75 (Sophia Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005006 | Orphan claim re-pointed Claims processor | CLM-429941 → UHC-58486-46 (Patrick Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005007 | Orphan claim re-pointed Claims processor | CLM-417438 → UHC-96426-29 (Samuel Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005008 | Orphan claim re-pointed Claims processor | CLM-422476 → UHC-02124-02 (Ryan Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005009 | Orphan claim re-pointed Claims processor | CLM-432510 → UHC-09172-06 (Susan Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005010 | Orphan claim re-pointed Claims processor | CLM-428393 → UHC-18772-45 (Aaron Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005011 | Orphan claim re-pointed Claims processor | CLM-402290 → UHC-69231-03 (Anna Young) |
| 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.