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-002490 | Orphan claim re-pointed Claims processor | CLM-430789 → UHC-03780-58 (Christian Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002491 | Orphan claim re-pointed Claims processor | CLM-421425 → UHC-59799-84 (Keith Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002492 | Orphan claim re-pointed Claims processor | CLM-420379 → UHC-08783-42 (George Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002493 | Orphan claim re-pointed Claims processor | CLM-414804 → UHC-45571-88 (Bradley Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002494 | Orphan claim re-pointed Claims processor | CLM-426862 → UHC-66706-90 (Eugene Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002495 | Orphan claim re-pointed Claims processor | CLM-401162 → UHC-93672-78 (Brenda Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002496 | Orphan claim re-pointed Claims processor | CLM-431614 → UHC-23119-97 (Sean Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002497 | Orphan claim re-pointed Claims processor | CLM-400332 → UHC-82887-97 (Terry Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002498 | Orphan claim re-pointed Claims processor | CLM-400565 → UHC-15572-90 (Janice Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002499 | Orphan claim re-pointed Claims processor | CLM-403053 → UHC-10330-79 (Richard Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002500 | Orphan claim re-pointed Claims processor | CLM-400147 → UHC-38970-15 (Carlos McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002501 | Orphan claim re-pointed Claims processor | CLM-432251 → UHC-95527-11 (Catherine Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002502 | Orphan claim re-pointed Claims processor | CLM-422861 → UHC-76606-90 (Diana Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002503 | Orphan claim re-pointed Claims processor | CLM-416955 → UHC-15695-65 (Janice Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002504 | Orphan claim re-pointed Claims processor | CLM-422448 → UHC-26911-50 (Jerry Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002505 | Orphan claim re-pointed Claims processor | CLM-416865 → UHC-27727-94 (Angela Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002506 | Orphan claim re-pointed Claims processor | CLM-426757 → UHC-95414-09 (Karn Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002507 | Orphan claim re-pointed Claims processor | CLM-422109 → UHC-09967-78 (Emily Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002508 | Orphan claim re-pointed Claims processor | CLM-402548 → UHC-77309-19 (Diana Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002509 | Orphan claim re-pointed Claims processor | CLM-429295 → UHC-67875-96 (Valentina Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002510 | Orphan claim re-pointed Claims processor | CLM-428445 → UHC-66752-04 (Michael Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002511 | Orphan claim re-pointed Claims processor | CLM-409615 → UHC-17279-10 (Bradley Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002512 | Orphan claim re-pointed Claims processor | CLM-400132 → UHC-55726-01 (Paul Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002513 | Orphan claim re-pointed Claims processor | CLM-419780 → UHC-40579-79 (Chris Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002514 | Orphan claim re-pointed Claims processor | CLM-415558 → UHC-59146-34 (Russell Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002515 | Orphan claim re-pointed Claims processor | CLM-416695 → UHC-83579-91 (Kimberly Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002516 | Orphan claim re-pointed Claims processor | CLM-429294 → UHC-22780-50 (Barbara Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002517 | Orphan claim re-pointed Claims processor | CLM-421651 → UHC-53180-18 (Mark Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002518 | Orphan claim re-pointed Claims processor | CLM-427359 → UHC-54568-43 (Evelyn Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002519 | Orphan claim re-pointed Claims processor | CLM-427944 → UHC-63689-60 (Nicholas Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002520 | Orphan claim re-pointed Claims processor | CLM-425012 → UHC-78384-87 (Aisha Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002521 | Orphan claim re-pointed Claims processor | CLM-412262 → UHC-76846-30 (Terry Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002522 | Orphan claim re-pointed Claims processor | CLM-414142 → UHC-72994-01 (Raymond Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002523 | Orphan claim re-pointed Claims processor | CLM-425869 → UHC-86154-31 (Kathleen Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002524 | Orphan claim re-pointed Claims processor | CLM-428323 → UHC-04552-01 (Michelle Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002525 | Orphan claim re-pointed Claims processor | CLM-415458 → UHC-89912-12 (Noah Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002526 | Orphan claim re-pointed Claims processor | CLM-416146 → UHC-22101-81 (Harold Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002527 | Orphan claim re-pointed Claims processor | CLM-420425 → UHC-29118-42 (Arjun Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002528 | Orphan claim re-pointed Claims processor | CLM-417930 → UHC-80393-86 (Kenneth Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002529 | Orphan claim re-pointed Claims processor | CLM-404196 → UHC-99236-88 (Elijah Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002530 | Orphan claim re-pointed Claims processor | CLM-415262 → UHC-36016-90 (Edward Olliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002531 | Orphan claim re-pointed Claims processor | CLM-415625 → UHC-25359-26 (Philip Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002532 | Orphan claim re-pointed Claims processor | CLM-424082 → UHC-08861-07 (Margaret Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002533 | Orphan claim re-pointed Claims processor | CLM-405425 → UHC-54662-88 (Brian Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002534 | Orphan claim re-pointed Claims processor | CLM-406458 → UHC-87369-79 (Kenneth Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002535 | Orphan claim re-pointed Claims processor | CLM-410947 → UHC-98661-87 (Christine Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002536 | Orphan claim re-pointed Claims processor | CLM-410937 → UHC-55505-62 (Danielle Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002537 | Orphan claim re-pointed Claims processor | CLM-412457 → UHC-08495-02 (Cynthia Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002538 | Orphan claim re-pointed Claims processor | CLM-425958 → UHC-09753-41 (Robert Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002539 | Orphan claim re-pointed Claims processor | CLM-419106 → UHC-65879-07 (Gregory Reid) |
| 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.