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-005062 | Orphan claim re-pointed Claims processor | CLM-400831 → UHC-00120-23 (Hannah Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005063 | Orphan claim re-pointed Claims processor | CLM-429967 → UHC-31923-24 (Shirley Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005064 | Orphan claim re-pointed Claims processor | CLM-426229 → UHC-72872-02 (Samantha Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005065 | Orphan claim re-pointed Claims processor | CLM-422385 → UHC-97031-33 (Teresa Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005066 | Orphan claim re-pointed Claims processor | CLM-401699 → UHC-66628-01 (Bryan Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005067 | Orphan claim re-pointed Claims processor | CLM-430915 → UHC-43468-04 (Justin Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005068 | Orphan claim re-pointed Claims processor | CLM-412139 → UHC-45255-44 (Julie Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005069 | Orphan claim re-pointed Claims processor | CLM-424574 → UHC-98151-65 (Gary Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005070 | Orphan claim re-pointed Claims processor | CLM-406369 → UHC-10686-47 (Carlos Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005071 | Orphan claim re-pointed Claims processor | CLM-426796 → UHC-34909-33 (Elijah Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005072 | Orphan claim re-pointed Claims processor | CLM-402988 → UHC-52113-23 (Joan Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005073 | Orphan claim re-pointed Claims processor | CLM-431172 → UHC-77933-88 (Zachary Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005074 | Orphan claim re-pointed Claims processor | CLM-403098 → UHC-60388-12 (Samantha Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005075 | Orphan claim re-pointed Claims processor | CLM-402741 → UHC-37593-70 (Emily Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005076 | Orphan claim re-pointed Claims processor | CLM-400255 → UHC-93581-67 (Marcus Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005077 | Orphan claim re-pointed Claims processor | CLM-423924 → UHC-34181-47 (Marcus Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005078 | Orphan claim re-pointed Claims processor | CLM-424140 → UHC-07458-97 (Sofia Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005079 | Orphan claim re-pointed Claims processor | CLM-424893 → UHC-79675-76 (Carl Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005080 | Orphan claim re-pointed Claims processor | CLM-426327 → UHC-26756-01 (Frank Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005081 | Orphan claim re-pointed Claims processor | CLM-431776 → UHC-44013-32 (Megan Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005082 | Orphan claim re-pointed Claims processor | CLM-407980 → UHC-72876-61 (Ralph Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005083 | Orphan claim re-pointed Claims processor | CLM-411277 → UHC-94025-69 (Frank Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005084 | Orphan claim re-pointed Claims processor | CLM-428302 → UHC-96291-49 (Jonathan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005085 | Orphan claim re-pointed Claims processor | CLM-413986 → UHC-53015-02 (Kimberly Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005086 | Orphan claim re-pointed Claims processor | CLM-417177 → UHC-25263-97 (Brian Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005087 | Orphan claim re-pointed Claims processor | CLM-405297 → UHC-25905-92 (Austin Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005088 | Orphan claim re-pointed Claims processor | CLM-428605 → UHC-14029-74 (Kathleen Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005089 | Orphan claim re-pointed Claims processor | CLM-413517 → UHC-65690-96 (Betsy Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005090 | Orphan claim re-pointed Claims processor | CLM-418828 → UHC-79922-12 (Natalie Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005091 | Orphan claim re-pointed Claims processor | CLM-415967 → UHC-98759-52 (Charles Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005092 | Orphan claim re-pointed Claims processor | CLM-423081 → UHC-88779-51 (Kenneth Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005093 | Orphan claim re-pointed Claims processor | CLM-410794 → UHC-42995-87 (Terry Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005094 | Orphan claim re-pointed Claims processor | CLM-411232 → UHC-89373-58 (Camila Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005095 | Orphan claim re-pointed Claims processor | CLM-412944 → UHC-05703-45 (Gloria Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005096 | Orphan claim re-pointed Claims processor | CLM-415675 → UHC-00963-84 (Charlotte Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005097 | Orphan claim re-pointed Claims processor | CLM-411604 → UHC-87151-33 (Noah Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005098 | Orphan claim re-pointed Claims processor | CLM-429807 → UHC-73352-65 (Jessica Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005099 | Orphan claim re-pointed Claims processor | CLM-430871 → UHC-41463-71 (Cheryl Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005100 | Orphan claim re-pointed Claims processor | CLM-421384 → UHC-73381-77 (Noah Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005101 | Orphan claim re-pointed Claims processor | CLM-417544 → UHC-51984-99 (Sandra Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005102 | Orphan claim re-pointed Claims processor | CLM-406784 → UHC-94097-91 (Robert Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005103 | Orphan claim re-pointed Claims processor | CLM-418407 → UHC-72907-79 (Sharon Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005104 | Orphan claim re-pointed Claims processor | CLM-431366 → UHC-36200-07 (Heather Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005105 | Orphan claim re-pointed Claims processor | CLM-400983 → UHC-71942-05 (David Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005106 | Orphan claim re-pointed Claims processor | CLM-403993 → UHC-88797-59 (Mark Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005107 | Orphan claim re-pointed Claims processor | CLM-416535 → UHC-49692-58 (Yuki Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005108 | Orphan claim re-pointed Claims processor | CLM-416089 → UHC-44982-76 (Jennifer Kellye) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005109 | Orphan claim re-pointed Claims processor | CLM-402426 → UHC-30142-52 (James Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005110 | Orphan claim re-pointed Claims processor | CLM-418330 → UHC-79140-14 (Brittany Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005111 | Orphan claim re-pointed Claims processor | CLM-413902 → UHC-07622-05 (Justin Johnson) |
| 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.