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-005462 | Orphan claim re-pointed Claims processor | CLM-418654 → UHC-62081-02 (Maria Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005463 | Orphan claim re-pointed Claims processor | CLM-408196 → UHC-56453-10 (Kelly Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005464 | Orphan claim re-pointed Claims processor | CLM-407113 → UHC-76710-68 (Katherine Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005465 | Orphan claim re-pointed Claims processor | CLM-419584 → UHC-23309-57 (Jesse Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005466 | Orphan claim re-pointed Claims processor | CLM-418717 → UHC-31272-97 (Jason Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005467 | Orphan claim re-pointed Claims processor | CLM-423593 → UHC-72123-01 (Rebecca Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005468 | Orphan claim re-pointed Claims processor | CLM-400590 → UHC-96079-84 (Kathleen Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005469 | Orphan claim re-pointed Claims processor | CLM-408476 → UHC-08239-66 (Eric Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005470 | Orphan claim re-pointed Claims processor | CLM-411460 → UHC-57349-54 (Carl Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005471 | Orphan claim re-pointed Claims processor | CLM-408820 → UHC-04938-33 (Zachary Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005472 | Orphan claim re-pointed Claims processor | CLM-402221 → UHC-52893-38 (Kimberly Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005473 | Orphan claim re-pointed Claims processor | CLM-430008 → UHC-97637-81 (Jacqueline Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005474 | Orphan claim re-pointed Claims processor | CLM-408873 → UHC-71648-01 (Helen Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005475 | Orphan claim re-pointed Claims processor | CLM-410617 → UHC-31632-29 (Ronald Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005476 | Orphan claim re-pointed Claims processor | CLM-421773 → UHC-12314-12 (Luis McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005477 | Orphan claim re-pointed Claims processor | CLM-407587 → UHC-32673-49 (Charles Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005478 | Orphan claim re-pointed Claims processor | CLM-403401 → UHC-28801-38 (Amanda Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005479 | Orphan claim re-pointed Claims processor | CLM-420749 → UHC-72641-27 (Laura Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005480 | Orphan claim re-pointed Claims processor | CLM-424622 → UHC-01081-09 (Jack Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005481 | Orphan claim re-pointed Claims processor | CLM-431152 → UHC-45378-23 (Jordan Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005482 | Orphan claim re-pointed Claims processor | CLM-429476 → UHC-65430-50 (Megan Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005483 | Orphan claim re-pointed Claims processor | CLM-400379 → UHC-39117-66 (Vicky Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005484 | Orphan claim re-pointed Claims processor | CLM-406645 → UHC-24696-32 (Denise King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005485 | Orphan claim re-pointed Claims processor | CLM-413941 → UHC-01330-32 (Albert Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005486 | Orphan claim re-pointed Claims processor | CLM-411994 → UHC-06277-65 (Maria Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005487 | Orphan claim re-pointed Claims processor | CLM-410052 → UHC-88337-04 (Peter Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005488 | Orphan claim re-pointed Claims processor | CLM-423406 → UHC-89016-23 (Philip Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005489 | Orphan claim re-pointed Claims processor | CLM-416932 → UHC-57453-86 (Stephen Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005490 | Orphan claim re-pointed Claims processor | CLM-417501 → UHC-24118-86 (Justin Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005491 | Orphan claim re-pointed Claims processor | CLM-415183 → UHC-81209-58 (Kathryn Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005492 | Orphan claim re-pointed Claims processor | CLM-420263 → UHC-63051-72 (Martha Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005493 | Orphan claim re-pointed Claims processor | CLM-417247 → UHC-89202-61 (Russell Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005494 | Orphan claim re-pointed Claims processor | CLM-419221 → UHC-90077-22 (Wayne Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005495 | Orphan claim re-pointed Claims processor | CLM-426788 → UHC-65062-39 (Christian Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005496 | Orphan claim re-pointed Claims processor | CLM-415535 → UHC-91234-39 (Kathryn Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005497 | Orphan claim re-pointed Claims processor | CLM-427067 → UHC-57083-46 (Sean Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005498 | Orphan claim re-pointed Claims processor | CLM-421480 → UHC-84578-81 (Bradley Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005499 | Orphan claim re-pointed Claims processor | CLM-411685 → UHC-00056-21 (Catherine Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005500 | Orphan claim re-pointed Claims processor | CLM-420171 → UHC-49338-06 (Grace Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005501 | Orphan claim re-pointed Claims processor | CLM-414081 → UHC-94329-01 (Rchard Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005502 | Orphan claim re-pointed Claims processor | CLM-409023 → UHC-86468-12 (Maria Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005503 | Orphan claim re-pointed Claims processor | CLM-408661 → UHC-82658-64 (Stephen Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005504 | Orphan claim re-pointed Claims processor | CLM-402999 → UHC-03857-67 (Bruce Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005505 | Orphan claim re-pointed Claims processor | CLM-412570 → UHC-54449-78 (Noah Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005506 | Orphan claim re-pointed Claims processor | CLM-408130 → UHC-87565-33 (Isabella Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005507 | Orphan claim re-pointed Claims processor | CLM-412248 → UHC-95420-85 (Julie Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005508 | Orphan claim re-pointed Claims processor | CLM-417028 → UHC-96463-73 (Cheryl Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005509 | Orphan claim re-pointed Claims processor | CLM-426109 → UHC-89377-66 (Marcus Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005510 | Orphan claim re-pointed Claims processor | CLM-407436 → UHC-93836-27 (Carol Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005511 | Orphan claim re-pointed Claims processor | CLM-412853 → UHC-02361-56 (Judith Vasquez) |
| 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.