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-005362 | Orphan claim re-pointed Claims processor | CLM-410157 → UHC-17351-28 (Joseph Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005363 | Orphan claim re-pointed Claims processor | CLM-412014 → UHC-62204-46 (Jerry Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005364 | Orphan claim re-pointed Claims processor | CLM-407582 → UHC-97436-25 (Robert Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005365 | Orphan claim re-pointed Claims processor | CLM-406482 → UHC-51488-43 (Logan Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005366 | Orphan claim re-pointed Claims processor | CLM-403398 → UHC-92193-29 (Jeremy Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005367 | Orphan claim re-pointed Claims processor | CLM-413875 → UHC-45394-30 (Christian Riiley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005368 | Orphan claim re-pointed Claims processor | CLM-424462 → UHC-31128-24 (Sara Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005369 | Orphan claim re-pointed Claims processor | CLM-409141 → UHC-27852-28 (Kelly Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005370 | Orphan claim re-pointed Claims processor | CLM-404547 → UHC-96000-34 (Teresa Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005371 | Orphan claim re-pointed Claims processor | CLM-413529 → UHC-81231-41 (Valentina Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005372 | Orphan claim re-pointed Claims processor | CLM-413022 → UHC-49553-83 (Julie Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005373 | Orphan claim re-pointed Claims processor | CLM-400979 → UHC-70835-52 (Camila Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005374 | Orphan claim re-pointed Claims processor | CLM-404551 → UHC-73800-42 (Patricia Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005375 | Orphan claim re-pointed Claims processor | CLM-413869 → UHC-40697-32 (Jacqueline Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005376 | Orphan claim re-pointed Claims processor | CLM-403770 → UHC-43670-05 (Kim Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005377 | Orphan claim re-pointed Claims processor | CLM-401821 → UHC-64480-79 (Jonathan Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005378 | Orphan claim re-pointed Claims processor | CLM-417302 → UHC-26038-09 (Russell Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005379 | Orphan claim re-pointed Claims processor | CLM-429687 → UHC-75613-83 (Charles McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005380 | Orphan claim re-pointed Claims processor | CLM-430553 → UHC-30333-12 (Kimberly Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005381 | Orphan claim re-pointed Claims processor | CLM-421072 → UHC-43983-84 (Mason Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005382 | Orphan claim re-pointed Claims processor | CLM-401253 → UHC-29310-13 (Carlos Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005383 | Orphan claim re-pointed Claims processor | CLM-421135 → UHC-72250-82 (Amber Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005384 | Orphan claim re-pointed Claims processor | CLM-413977 → UHC-24813-74 (Lisa Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005385 | Orphan claim re-pointed Claims processor | CLM-426579 → UHC-28952-82 (Ralph Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005386 | Orphan claim re-pointed Claims processor | CLM-407024 → UHC-96213-84 (Yuki Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005387 | Orphan claim re-pointed Claims processor | CLM-413792 → UHC-19461-15 (Denise Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005388 | Orphan claim re-pointed Claims processor | CLM-421923 → UHC-34912-88 (Theresa Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005389 | Orphan claim re-pointed Claims processor | CLM-411373 → UHC-54013-72 (Gregory Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005390 | Orphan claim re-pointed Claims processor | CLM-400663 → UHC-21000-52 (Nicole Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005391 | Orphan claim re-pointed Claims processor | CLM-405265 → UHC-90372-35 (Eugene Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005392 | Orphan claim re-pointed Claims processor | CLM-410021 → UHC-88472-34 (Jose Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005393 | Orphan claim re-pointed Claims processor | CLM-423511 → UHC-19511-99 (Raymond Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005394 | Orphan claim re-pointed Claims processor | CLM-403573 → UHC-48277-68 (Sandra Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005395 | Orphan claim re-pointed Claims processor | CLM-430969 → UHC-86487-27 (Sharon Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005396 | Orphan claim re-pointed Claims processor | CLM-410962 → UHC-72665-54 (Martha Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005397 | Orphan claim re-pointed Claims processor | CLM-407199 → UHC-82425-52 (Henry Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005398 | Orphan claim re-pointed Claims processor | CLM-418845 → UHC-84212-31 (David Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005399 | Orphan claim re-pointed Claims processor | CLM-426392 → UHC-82755-81 (Teresa Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005400 | Orphan claim re-pointed Claims processor | CLM-403114 → UHC-58119-10 (George Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005401 | Orphan claim re-pointed Claims processor | CLM-419209 → UHC-96845-24 (Judith Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005402 | Orphan claim re-pointed Claims processor | CLM-422002 → UHC-25901-27 (Sara Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005403 | Orphan claim re-pointed Claims processor | CLM-406560 → UHC-88200-21 (Ashley Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005404 | Orphan claim re-pointed Claims processor | CLM-400483 → UHC-37270-06 (Hiroshi Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005405 | Orphan claim re-pointed Claims processor | CLM-404436 → UHC-46549-70 (Charlotte Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005406 | Orphan claim re-pointed Claims processor | CLM-403491 → UHC-91422-70 (Martha Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005407 | Orphan claim re-pointed Claims processor | CLM-429556 → UHC-17159-14 (Alexis Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005408 | Orphan claim re-pointed Claims processor | CLM-413981 → UHC-05998-73 (Kayla Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005409 | Orphan claim re-pointed Claims processor | CLM-406440 → UHC-52357-03 (Angela King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005410 | Orphan claim re-pointed Claims processor | CLM-417503 → UHC-24535-03 (Carolyn Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005411 | Orphan claim re-pointed Claims processor | CLM-426411 → UHC-53313-88 (Frances Payne) |
| 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.