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-005212 | Orphan claim re-pointed Claims processor | CLM-401810 → UHC-69078-97 (Jacqueline Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005213 | Orphan claim re-pointed Claims processor | CLM-418743 → UHC-44354-85 (Jonathan Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005214 | Orphan claim re-pointed Claims processor | CLM-419541 → UHC-13791-50 (Charlotte Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005215 | Orphan claim re-pointed Claims processor | CLM-402135 → UHC-05123-51 (Danielle Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005216 | Orphan claim re-pointed Claims processor | CLM-405478 → UHC-62597-73 (Mei Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005217 | Orphan claim re-pointed Claims processor | CLM-404415 → UHC-24401-43 (Janet Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005218 | Orphan claim re-pointed Claims processor | CLM-427227 → UHC-71794-95 (Michelle Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005219 | Orphan claim re-pointed Claims processor | CLM-417243 → UHC-78000-99 (Joyce Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005220 | Orphan claim re-pointed Claims processor | CLM-408819 → UHC-04938-33 (Zachary Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005221 | Orphan claim re-pointed Claims processor | CLM-421661 → UHC-86333-10 (Heather Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005222 | Orphan claim re-pointed Claims processor | CLM-411271 → UHC-35079-82 (Stephanie Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005223 | Orphan claim re-pointed Claims processor | CLM-411015 → UHC-42385-49 (Brittany Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005224 | Orphan claim re-pointed Claims processor | CLM-429921 → UHC-23913-30 (Richard Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005225 | Orphan claim re-pointed Claims processor | CLM-420685 → UHC-74157-95 (Michael Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005226 | Orphan claim re-pointed Claims processor | CLM-417364 → UHC-08070-07 (Marcus Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005227 | Orphan claim re-pointed Claims processor | CLM-424763 → UHC-02610-34 (Grace Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005228 | Orphan claim re-pointed Claims processor | CLM-426314 → UHC-46621-13 (Mark Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005229 | Orphan claim re-pointed Claims processor | CLM-424033 → UHC-45400-47 (Megan Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005230 | Orphan claim re-pointed Claims processor | CLM-405677 → UHC-36092-77 (Barbara Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005231 | Orphan claim re-pointed Claims processor | CLM-419375 → UHC-77634-20 (Jeffrey Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005232 | Orphan claim re-pointed Claims processor | CLM-408244 → UHC-24383-41 (Valentina Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005233 | Orphan claim re-pointed Claims processor | CLM-421913 → UHC-40771-60 (Dylan White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005234 | Orphan claim re-pointed Claims processor | CLM-420456 → UHC-27706-65 (Jennifer Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005235 | Orphan claim re-pointed Claims processor | CLM-418344 → UHC-09522-48 (Carol Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005236 | Orphan claim re-pointed Claims processor | CLM-415091 → UHC-18514-12 (Daniel Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005237 | Orphan claim re-pointed Claims processor | CLM-403527 → UHC-74052-85 (Terry Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005238 | Orphan claim re-pointed Claims processor | CLM-431900 → UHC-38371-52 (Margaret Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005239 | Orphan claim re-pointed Claims processor | CLM-413387 → UHC-80648-57 (Elijah Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005240 | Orphan claim re-pointed Claims processor | CLM-412165 → UHC-12094-80 (Nancy Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005241 | Orphan claim re-pointed Claims processor | CLM-431218 → UHC-50579-26 (Amanda Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005242 | Orphan claim re-pointed Claims processor | CLM-416410 → UHC-16604-78 (Amber Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005243 | Orphan claim re-pointed Claims processor | CLM-420670 → UHC-10822-60 (Nathan Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005244 | Orphan claim re-pointed Claims processor | CLM-421891 → UHC-11506-03 (Camila Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005245 | Orphan claim re-pointed Claims processor | CLM-427731 → UHC-84064-26 (Mateo Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005246 | Orphan claim re-pointed Claims processor | CLM-421120 → UHC-85610-69 (Evelyn Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005247 | Orphan claim re-pointed Claims processor | CLM-422489 → UHC-55634-10 (Paul Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005248 | Orphan claim re-pointed Claims processor | CLM-430315 → UHC-74911-42 (Ethan Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005249 | Orphan claim re-pointed Claims processor | CLM-411594 → UHC-89738-84 (Amanda Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005250 | Orphan claim re-pointed Claims processor | CLM-410449 → UHC-64090-94 (Diane Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005251 | Orphan claim re-pointed Claims processor | CLM-424285 → UHC-06107-12 (Aisha Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005252 | Orphan claim re-pointed Claims processor | CLM-419180 → UHC-27461-26 (Elijah Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005253 | Orphan claim re-pointed Claims processor | CLM-405218 → UHC-80110-73 (Carol Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005254 | Orphan claim re-pointed Claims processor | CLM-415770 → UHC-71756-75 (Tyler Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005255 | Orphan claim re-pointed Claims processor | CLM-400876 → UHC-70193-72 (Karen Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005256 | Orphan claim re-pointed Claims processor | CLM-427523 → UHC-84824-01 (Judith Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005257 | Orphan claim re-pointed Claims processor | CLM-408316 → UHC-49084-09 (Susan Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005258 | Orphan claim re-pointed Claims processor | CLM-421498 → UHC-42424-16 (William Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005259 | Orphan claim re-pointed Claims processor | CLM-410320 → UHC-79386-51 (Mark Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005260 | Orphan claim re-pointed Claims processor | CLM-416520 → UHC-56603-65 (Matthew Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005261 | Orphan claim re-pointed Claims processor | CLM-421852 → UHC-38780-55 (Eric Watson) |
| 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.