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-005112 | Orphan claim re-pointed Claims processor | CLM-407856 → UHC-88715-46 (Ronald Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005113 | Orphan claim re-pointed Claims processor | CLM-407608 → UHC-88336-76 (Richard Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005114 | Orphan claim re-pointed Claims processor | CLM-412772 → UHC-31938-22 (Henry Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005115 | Orphan claim re-pointed Claims processor | CLM-417691 → UHC-22861-85 (Sophia Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005116 | Orphan claim re-pointed Claims processor | CLM-428201 → UHC-45914-08 (George Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005117 | Orphan claim re-pointed Claims processor | CLM-409085 → UHC-61419-84 (Kathryn Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005118 | Orphan claim re-pointed Claims processor | CLM-420893 → UHC-34115-12 (Benjamin Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005119 | Orphan claim re-pointed Claims processor | CLM-401457 → UHC-82145-43 (Teresa Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005120 | Orphan claim re-pointed Claims processor | CLM-415634 → UHC-39770-46 (Amanda Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005121 | Orphan claim re-pointed Claims processor | CLM-404643 → UHC-30998-65 (Sean Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005122 | Orphan claim re-pointed Claims processor | CLM-406201 → UHC-35361-14 (Kathryn Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005123 | Orphan claim re-pointed Claims processor | CLM-404276 → UHC-66259-56 (Virginia Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005124 | Orphan claim re-pointed Claims processor | CLM-426697 → UHC-39362-82 (Dennis Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005125 | Orphan claim re-pointed Claims processor | CLM-402109 → UHC-15907-13 (Emily Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005126 | Orphan claim re-pointed Claims processor | CLM-411719 → UHC-72502-21 (Elijah Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005127 | Orphan claim re-pointed Claims processor | CLM-424740 → UHC-10537-45 (Santiago Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005128 | Orphan claim re-pointed Claims processor | CLM-414150 → UHC-07842-57 (Ralph Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005129 | Orphan claim re-pointed Claims processor | CLM-415922 → UHC-89293-82 (Marcus Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005130 | Orphan claim re-pointed Claims processor | CLM-428112 → UHC-75946-86 (Janice Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005131 | Orphan claim re-pointed Claims processor | CLM-422569 → UHC-58555-26 (Barbara Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005132 | Orphan claim re-pointed Claims processor | CLM-420799 → UHC-37202-97 (Carlos Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005133 | Orphan claim re-pointed Claims processor | CLM-421980 → UHC-10502-17 (Grace Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005134 | Orphan claim re-pointed Claims processor | CLM-418965 → UHC-23580-88 (Wei Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005135 | Orphan claim re-pointed Claims processor | CLM-413480 → UHC-29432-01 (Carol Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005136 | Orphan claim re-pointed Claims processor | CLM-427530 → UHC-01760-71 (Elijah Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005137 | Orphan claim re-pointed Claims processor | CLM-419547 → UHC-87606-64 (Vicky Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005138 | Orphan claim re-pointed Claims processor | CLM-418979 → UHC-27686-30 (Mei Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005139 | Orphan claim re-pointed Claims processor | CLM-414482 → UHC-36583-04 (Joan Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005140 | Orphan claim re-pointed Claims processor | CLM-417763 → UHC-72109-49 (Mason Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005141 | Orphan claim re-pointed Claims processor | CLM-419857 → UHC-68572-14 (George Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005142 | Orphan claim re-pointed Claims processor | CLM-406997 → UHC-30064-04 (Carol Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005143 | Orphan claim re-pointed Claims processor | CLM-401667 → UHC-23385-68 (Danielle Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005144 | Orphan claim re-pointed Claims processor | CLM-429962 → UHC-13305-47 (Betty Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005145 | Orphan claim re-pointed Claims processor | CLM-412274 → UHC-32087-19 (James Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005146 | Orphan claim re-pointed Claims processor | CLM-405832 → UHC-76869-45 (Sara Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005147 | Orphan claim re-pointed Claims processor | CLM-431909 → UHC-23354-60 (Zachary Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005148 | Orphan claim re-pointed Claims processor | CLM-421329 → UHC-70908-34 (Rebecca Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005149 | Orphan claim re-pointed Claims processor | CLM-403701 → UHC-02842-96 (Arthur Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005150 | Orphan claim re-pointed Claims processor | CLM-429278 → UHC-89686-04 (John Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005151 | Orphan claim re-pointed Claims processor | CLM-405429 → UHC-44888-61 (Betty Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005152 | Orphan claim re-pointed Claims processor | CLM-430406 → UHC-20218-54 (Michelle Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005153 | Orphan claim re-pointed Claims processor | CLM-427673 → UHC-01658-44 (Aisha Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005154 | Orphan claim re-pointed Claims processor | CLM-415800 → UHC-76630-85 (Aan Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005155 | Orphan claim re-pointed Claims processor | CLM-423666 → UHC-70290-96 (Frances Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005156 | Orphan claim re-pointed Claims processor | CLM-427967 → UHC-08079-42 (Nancy James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005157 | Orphan claim re-pointed Claims processor | CLM-411312 → UHC-37285-52 (Judy Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005158 | Orphan claim re-pointed Claims processor | CLM-425195 → UHC-41854-94 (Charlotte Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005159 | Orphan claim re-pointed Claims processor | CLM-416631 → UHC-67243-29 (Dylan Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005160 | Orphan claim re-pointed Claims processor | CLM-417185 → UHC-86887-23 (Ronald Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005161 | Orphan claim re-pointed Claims processor | CLM-426198 → UHC-91434-17 (Joan Spencer) |
| 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.