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-005162 | Orphan claim re-pointed Claims processor | CLM-420833 → UHC-99124-42 (Debra Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005163 | Orphan claim re-pointed Claims processor | CLM-426532 → UHC-05114-18 (Ralph Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005164 | Orphan claim re-pointed Claims processor | CLM-425603 → UHC-75343-29 (Lauren Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005165 | Orphan claim re-pointed Claims processor | CLM-411338 → UHC-10370-08 (Margaret Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005166 | Orphan claim re-pointed Claims processor | CLM-410849 → UHC-67859-40 (Charlotte Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005167 | Orphan claim re-pointed Claims processor | CLM-419804 → UHC-68432-82 (Ann Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005168 | Orphan claim re-pointed Claims processor | CLM-418264 → UHC-14218-79 (Vincent Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005169 | Orphan claim re-pointed Claims processor | CLM-431322 → UHC-52424-70 (Bradley Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005170 | Orphan claim re-pointed Claims processor | CLM-432192 → UHC-85757-15 (Justin Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005171 | Orphan claim re-pointed Claims processor | CLM-426014 → UHC-56199-92 (Pamela Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005172 | Orphan claim re-pointed Claims processor | CLM-410557 → UHC-98355-06 (Thomas Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005173 | Orphan claim re-pointed Claims processor | CLM-404111 → UHC-07829-56 (Ahmed Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005174 | Orphan claim re-pointed Claims processor | CLM-403009 → UHC-94231-07 (George Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005175 | Orphan claim re-pointed Claims processor | CLM-417133 → UHC-62981-14 (Harold Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005176 | Orphan claim re-pointed Claims processor | CLM-409326 → UHC-22617-58 (Anna Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005177 | Orphan claim re-pointed Claims processor | CLM-429327 → UHC-09711-54 (Carl Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005178 | Orphan claim re-pointed Claims processor | CLM-403910 → UHC-63162-84 (Sofia Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005179 | Orphan claim re-pointed Claims processor | CLM-410441 → UHC-84531-10 (Amy Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005180 | Orphan claim re-pointed Claims processor | CLM-428746 → UHC-39705-39 (Priya Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005181 | Orphan claim re-pointed Claims processor | CLM-406109 → UHC-75072-26 (Adam Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005182 | Orphan claim re-pointed Claims processor | CLM-417396 → UHC-95529-67 (Ahmmed Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005183 | Orphan claim re-pointed Claims processor | CLM-429561 → UHC-66040-77 (Bruce Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005184 | Orphan claim re-pointed Claims processor | CLM-418296 → UHC-08143-43 (Nicole Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005185 | Orphan claim re-pointed Claims processor | CLM-426937 → UHC-79958-90 (Susan Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005186 | Orphan claim re-pointed Claims processor | CLM-406362 → UHC-21999-44 (Alice Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005187 | Orphan claim re-pointed Claims processor | CLM-402230 → UHC-76069-44 (Daniel Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005188 | Orphan claim re-pointed Claims processor | CLM-425388 → UHC-36590-35 (Shirley Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005189 | Orphan claim re-pointed Claims processor | CLM-415368 → UHC-75069-05 (Daniel Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005190 | Orphan claim re-pointed Claims processor | CLM-408358 → UHC-86549-94 (Jacqueline Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005191 | Orphan claim re-pointed Claims processor | CLM-426043 → UHC-76267-15 (Sara Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005192 | Orphan claim re-pointed Claims processor | CLM-428046 → UHC-95060-50 (Roger Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005193 | Orphan claim re-pointed Claims processor | CLM-425287 → UHC-54583-90 (Ana Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005194 | Orphan claim re-pointed Claims processor | CLM-405743 → UHC-33507-96 (Victoria Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005195 | Orphan claim re-pointed Claims processor | CLM-423760 → UHC-58583-12 (Gutierrez Helen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005196 | Orphan claim re-pointed Claims processor | CLM-418602 → UHC-06049-09 (Marilyn Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005197 | Orphan claim re-pointed Claims processor | CLM-428475 → UHC-60855-59 (Martha Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005198 | Orphan claim re-pointed Claims processor | CLM-429777 → UHC-92614-98 (Bruce Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005199 | Orphan claim re-pointed Claims processor | CLM-404484 → UHC-79339-20 (Henry Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005200 | Orphan claim re-pointed Claims processor | CLM-406105 → UHC-82611-55 (Vincent Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005201 | Orphan claim re-pointed Claims processor | CLM-409590 → UHC-00556-15 (Adam Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005202 | Orphan claim re-pointed Claims processor | CLM-418861 → UHC-02229-10 (Luis Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005203 | Orphan claim re-pointed Claims processor | CLM-423016 → UHC-07292-09 (Jen Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005204 | Orphan claim re-pointed Claims processor | CLM-432116 → UHC-38378-27 (Andrea Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005205 | Orphan claim re-pointed Claims processor | CLM-400072 → UHC-30893-25 (Camila Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005206 | Orphan claim re-pointed Claims processor | CLM-418600 → UHC-69380-61 (Deborah Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005207 | Orphan claim re-pointed Claims processor | CLM-401958 → UHC-58974-57 (Charlotte Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005208 | Orphan claim re-pointed Claims processor | CLM-427503 → UHC-45751-58 (Wayne Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005209 | Orphan claim re-pointed Claims processor | CLM-413051 → UHC-48159-34 (Carolny Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005210 | Orphan claim re-pointed Claims processor | CLM-412703 → UHC-88524-21 (Brian Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005211 | Orphan claim re-pointed Claims processor | CLM-405500 → UHC-49365-80 (Alexis Howell) |
| 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.