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-005262 | Orphan claim re-pointed Claims processor | CLM-428743 → UHC-54310-48 (Sharon Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005263 | Orphan claim re-pointed Claims processor | CLM-405769 → UHC-82443-76 (Austin Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005264 | Orphan claim re-pointed Claims processor | CLM-417610 → UHC-13382-61 (Maria Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005265 | Orphan claim re-pointed Claims processor | CLM-413659 → UHC-54331-87 (Timothy Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005266 | Orphan claim re-pointed Claims processor | CLM-422586 → UHC-87605-29 (Charles Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005267 | Orphan claim re-pointed Claims processor | CLM-411483 → UHC-01154-91 (Valentina Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005268 | Orphan claim re-pointed Claims processor | CLM-407016 → UHC-22573-16 (Daniel Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005269 | Orphan claim re-pointed Claims processor | CLM-405647 → UHC-12381-44 (Jordan Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005270 | Orphan claim re-pointed Claims processor | CLM-414516 → UHC-95289-30 (Kimberly Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005271 | Orphan claim re-pointed Claims processor | CLM-406094 → UHC-35139-26 (Amber Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005272 | Orphan claim re-pointed Claims processor | CLM-412528 → UHC-53297-26 (Jon Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005273 | Orphan claim re-pointed Claims processor | CLM-414372 → UHC-40970-34 (Brian Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005274 | Orphan claim re-pointed Claims processor | CLM-413426 → UHC-44275-91 (Elizabeth Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005275 | Orphan claim re-pointed Claims processor | CLM-421801 → UHC-68587-26 (Harold Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005276 | Orphan claim re-pointed Claims processor | CLM-413352 → UHC-87150-10 (Sarah Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005277 | Orphan claim re-pointed Claims processor | CLM-426067 → UHC-84217-49 (Alexander Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005278 | Orphan claim re-pointed Claims processor | CLM-402814 → UHC-52239-76 (Brandon Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005279 | Orphan claim re-pointed Claims processor | CLM-424631 → UHC-38096-98 (Stephen Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005280 | Orphan claim re-pointed Claims processor | CLM-419999 → UHC-95158-61 (Steven Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005281 | Orphan claim re-pointed Claims processor | CLM-403549 → UHC-39760-46 (Carolyn Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005282 | Orphan claim re-pointed Claims processor | CLM-432037 → UHC-17259-22 (Jack Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005283 | Orphan claim re-pointed Claims processor | CLM-401292 → UHC-32322-15 (Christopher Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005284 | Orphan claim re-pointed Claims processor | CLM-428739 → UHC-21212-69 (Carl Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005285 | Orphan claim re-pointed Claims processor | CLM-431074 → UHC-00720-73 (Brenda Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005286 | Orphan claim re-pointed Claims processor | CLM-422397 → UHC-60575-35 (Betty Rilley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005287 | Orphan claim re-pointed Claims processor | CLM-416984 → UHC-34661-92 (Walter Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005288 | Orphan claim re-pointed Claims processor | CLM-404793 → UHC-96131-84 (Patrick Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005289 | Orphan claim re-pointed Claims processor | CLM-420660 → UHC-30457-37 (Melissa Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005290 | Orphan claim re-pointed Claims processor | CLM-432263 → UHC-24573-21 (Bryan Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005291 | Orphan claim re-pointed Claims processor | CLM-418974 → UHC-07694-89 (Elizabeth Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005292 | Orphan claim re-pointed Claims processor | CLM-412741 → UHC-04603-36 (Harold Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005293 | Orphan claim re-pointed Claims processor | CLM-411508 → UHC-73306-19 (Juan Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005294 | Orphan claim re-pointed Claims processor | CLM-410240 → UHC-81933-20 (Scott Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005295 | Orphan claim re-pointed Claims processor | CLM-409192 → UHC-85772-60 (Jerry Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005296 | Orphan claim re-pointed Claims processor | CLM-425402 → UHC-43649-73 (Isabella Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005297 | Orphan claim re-pointed Claims processor | CLM-410009 → UHC-50913-71 (Cynthia Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005298 | Orphan claim re-pointed Claims processor | CLM-413526 → UHC-96567-22 (Benjamin Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005299 | Orphan claim re-pointed Claims processor | CLM-404328 → UHC-34703-52 (Ana Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005300 | Orphan claim re-pointed Claims processor | CLM-411865 → UHC-20637-25 (Helen West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005301 | Orphan claim re-pointed Claims processor | CLM-411953 → UHC-77075-98 (Sandra Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005302 | Orphan claim re-pointed Claims processor | CLM-423208 → UHC-92535-52 (Willie Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005303 | Orphan claim re-pointed Claims processor | CLM-425312 → UHC-53770-84 (Ryan Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005304 | Orphan claim re-pointed Claims processor | CLM-410439 → UHC-82278-33 (Martha Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005305 | Orphan claim re-pointed Claims processor | CLM-402278 → UHC-75638-23 (Doris Haarper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005306 | Orphan claim re-pointed Claims processor | CLM-405222 → UHC-28414-39 (Lsa Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005307 | Orphan claim re-pointed Claims processor | CLM-418233 → UHC-38273-80 (Eugene Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005308 | Orphan claim re-pointed Claims processor | CLM-401085 → UHC-79516-15 (Gabriel Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005309 | Orphan claim re-pointed Claims processor | CLM-413904 → UHC-33199-01 (Sarah Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005310 | Orphan claim re-pointed Claims processor | CLM-428187 → UHC-23414-82 (Victoria Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005311 | Orphan claim re-pointed Claims processor | CLM-400114 → UHC-76230-29 (Nancy Patel) |
| 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.