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-005312 | Orphan claim re-pointed Claims processor | CLM-425114 → UHC-96746-66 (Christine White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005313 | Orphan claim re-pointed Claims processor | CLM-418964 → UHC-23580-88 (Wei Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005314 | Orphan claim re-pointed Claims processor | CLM-414963 → UHC-56461-21 (Lucia Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005315 | Orphan claim re-pointed Claims processor | CLM-414448 → UHC-92729-78 (Emily Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005316 | Orphan claim re-pointed Claims processor | CLM-408138 → UHC-72343-79 (Joseph Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005317 | Orphan claim re-pointed Claims processor | CLM-425368 → UHC-34450-15 (Aaron Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005318 | Orphan claim re-pointed Claims processor | CLM-422251 → UHC-31187-24 (Daniel Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005319 | Orphan claim re-pointed Claims processor | CLM-406633 → UHC-85810-37 (Joe Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005320 | Orphan claim re-pointed Claims processor | CLM-427718 → UHC-59486-30 (David Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005321 | Orphan claim re-pointed Claims processor | CLM-409486 → UHC-82032-35 (Margaret Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005322 | Orphan claim re-pointed Claims processor | CLM-409993 → UHC-77619-57 (Gary Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005323 | Orphan claim re-pointed Claims processor | CLM-427935 → UHC-95217-49 (Amber Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005324 | Orphan claim re-pointed Claims processor | CLM-401612 → UHC-64585-07 (Joan Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005325 | Orphan claim re-pointed Claims processor | CLM-429146 → UHC-29743-13 (Nancy Morles) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005326 | Orphan claim re-pointed Claims processor | CLM-416825 → UHC-56670-99 (Cynthia Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005327 | Orphan claim re-pointed Claims processor | CLM-401736 → UHC-23813-69 (John Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005328 | Orphan claim re-pointed Claims processor | CLM-413655 → UHC-48730-84 (Emily Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005329 | Orphan claim re-pointed Claims processor | CLM-414008 → UHC-88577-54 (Thomas Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005330 | Orphan claim re-pointed Claims processor | CLM-427183 → UHC-78868-43 (Jacob Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005331 | Orphan claim re-pointed Claims processor | CLM-422527 → UHC-51631-22 (Mark Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005332 | Orphan claim re-pointed Claims processor | CLM-414560 → UHC-22109-31 (Jessica Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005333 | Orphan claim re-pointed Claims processor | CLM-413213 → UHC-96648-95 (Frances Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005334 | Orphan claim re-pointed Claims processor | CLM-403255 → UHC-85894-33 (Gary Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005335 | Orphan claim re-pointed Claims processor | CLM-408348 → UHC-57936-49 (Stephen Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005336 | Orphan claim re-pointed Claims processor | CLM-413825 → UHC-64201-19 (Betty Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005337 | Orphan claim re-pointed Claims processor | CLM-430728 → UHC-27796-57 (Austin Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005338 | Orphan claim re-pointed Claims processor | CLM-431889 → UHC-64261-86 (Carl Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005339 | Orphan claim re-pointed Claims processor | CLM-418459 → UHC-94134-10 (Lawrence Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005340 | Orphan claim re-pointed Claims processor | CLM-419061 → UHC-98920-26 (Donna Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005341 | Orphan claim re-pointed Claims processor | CLM-432278 → UHC-32126-41 (Teresa Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005342 | Orphan claim re-pointed Claims processor | CLM-415765 → UHC-11129-02 (Cheryl Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005343 | Orphan claim re-pointed Claims processor | CLM-401811 → UHC-69078-97 (Jacqueline Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005344 | Orphan claim re-pointed Claims processor | CLM-408624 → UHC-87112-20 (Diego Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005345 | Orphan claim re-pointed Claims processor | CLM-422656 → UHC-24954-02 (Gary Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005346 | Orphan claim re-pointed Claims processor | CLM-410892 → UHC-47517-65 (Hiroshi Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005347 | Orphan claim re-pointed Claims processor | CLM-432758 → UHC-84285-56 (Adam Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005348 | Orphan claim re-pointed Claims processor | CLM-416515 → UHC-75588-91 (Steven Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005349 | Orphan claim re-pointed Claims processor | CLM-409484 → UHC-82032-35 (Margaret Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005350 | Orphan claim re-pointed Claims processor | CLM-413323 → UHC-03845-70 (Eugene Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005351 | Orphan claim re-pointed Claims processor | CLM-414257 → UHC-03691-68 (Ralph Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005352 | Orphan claim re-pointed Claims processor | CLM-427407 → UHC-09449-40 (Jeff Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005353 | Orphan claim re-pointed Claims processor | CLM-424605 → UHC-09027-77 (Frances Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005354 | Orphan claim re-pointed Claims processor | CLM-421043 → UHC-18091-41 (Emily Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005355 | Orphan claim re-pointed Claims processor | CLM-421227 → UHC-02734-71 (Joan Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005356 | Orphan claim re-pointed Claims processor | CLM-423643 → UHC-08974-21 (Daniel Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005357 | Orphan claim re-pointed Claims processor | CLM-426728 → UHC-89508-38 (Jordan Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005358 | Orphan claim re-pointed Claims processor | CLM-412002 → UHC-21780-50 (Joshua Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005359 | Orphan claim re-pointed Claims processor | CLM-417382 → UHC-17934-72 (Natalie Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005360 | Orphan claim re-pointed Claims processor | CLM-411360 → UHC-26940-05 (Julie Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005361 | Orphan claim re-pointed Claims processor | CLM-422956 → UHC-76265-13 (Kathleen Fisher) |
| 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.