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-005512 | Orphan claim re-pointed Claims processor | CLM-417907 → UHC-03687-10 (Tricia Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005513 | Orphan claim re-pointed Claims processor | CLM-418070 → UHC-80886-56 (Kayla Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005514 | Orphan claim re-pointed Claims processor | CLM-421309 → UHC-39091-36 (Carol Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005515 | Orphan claim re-pointed Claims processor | CLM-417187 → UHC-87854-09 (Julia Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005516 | Orphan claim re-pointed Claims processor | CLM-406323 → UHC-19581-65 (Sara Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005517 | Orphan claim re-pointed Claims processor | CLM-432769 → UHC-11191-55 (Margaret Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005518 | Orphan claim re-pointed Claims processor | CLM-409921 → UHC-51707-54 (Alexis Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005519 | Orphan claim re-pointed Claims processor | CLM-402644 → UHC-52043-76 (Roy Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005520 | Orphan claim re-pointed Claims processor | CLM-422912 → UHC-80624-66 (Steven McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005521 | Orphan claim re-pointed Claims processor | CLM-424129 → UHC-61657-92 (Wei Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005522 | Orphan claim re-pointed Claims processor | CLM-431841 → UHC-72484-78 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005523 | Orphan claim re-pointed Claims processor | CLM-407000 → UHC-64753-11 (Megan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005524 | Orphan claim re-pointed Claims processor | CLM-417003 → UHC-69372-05 (Dylan Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005525 | Orphan claim re-pointed Claims processor | CLM-405013 → UHC-78188-71 (Arthur Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005526 | Orphan claim re-pointed Claims processor | CLM-430560 → UHC-50821-50 (George Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005527 | Orphan claim re-pointed Claims processor | CLM-422373 → UHC-54681-25 (Jessica Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005528 | Orphan claim re-pointed Claims processor | CLM-430047 → UHC-24100-19 (Martha Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005529 | Orphan claim re-pointed Claims processor | CLM-408117 → UHC-79098-85 (Elijah Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005530 | Orphan claim re-pointed Claims processor | CLM-428560 → UHC-51145-14 (Samuel Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005531 | Orphan claim re-pointed Claims processor | CLM-431719 → UHC-22895-17 (Maria Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005532 | Orphan claim re-pointed Claims processor | CLM-431625 → UHC-39693-44 (Bruce Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005533 | Orphan claim re-pointed Claims processor | CLM-432153 → UHC-22051-95 (Denise Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005534 | Orphan claim re-pointed Claims processor | CLM-419314 → UHC-78221-66 (Kayla McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005535 | Orphan claim re-pointed Claims processor | CLM-413417 → UHC-03506-53 (Bobby Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005536 | Orphan claim re-pointed Claims processor | CLM-429987 → UHC-06749-57 (Raymond Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005537 | Orphan claim re-pointed Claims processor | CLM-405081 → UHC-83296-48 (Sofia Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005538 | Orphan claim re-pointed Claims processor | CLM-401227 → UHC-92472-25 (Danielle Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005539 | Orphan claim re-pointed Claims processor | CLM-403588 → UHC-69793-41 (Bradley Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005540 | Orphan claim re-pointed Claims processor | CLM-423196 → UHC-36095-33 (Christine Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005541 | Orphan claim re-pointed Claims processor | CLM-427331 → UHC-26863-57 (Camila Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005542 | Orphan claim re-pointed Claims processor | CLM-405083 → UHC-84948-25 (Judith Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005543 | Orphan claim re-pointed Claims processor | CLM-416851 → UHC-66551-78 (James White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005544 | Orphan claim re-pointed Claims processor | CLM-418245 → UHC-42716-67 (Amy McCy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005545 | Orphan claim re-pointed Claims processor | CLM-431748 → UHC-57676-62 (Mariana Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005546 | Orphan claim re-pointed Claims processor | CLM-402129 → UHC-34634-77 (Emily Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005547 | Orphan claim re-pointed Claims processor | CLM-422830 → UHC-24778-33 (Timothy Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005548 | Orphan claim re-pointed Claims processor | CLM-402473 → UHC-31085-72 (Judith Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005549 | Orphan claim re-pointed Claims processor | CLM-431257 → UHC-05043-11 (Andrew Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005550 | Orphan claim re-pointed Claims processor | CLM-431361 → UHC-27985-96 (Kimberly Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005551 | Orphan claim re-pointed Claims processor | CLM-407521 → UHC-46334-94 (Keith Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005552 | Orphan claim re-pointed Claims processor | CLM-426779 → UHC-82540-45 (Susan Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005553 | Orphan claim re-pointed Claims processor | CLM-425721 → UHC-04206-33 (Kathleen Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005554 | Orphan claim re-pointed Claims processor | CLM-414212 → UHC-72976-93 (Zachary Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005555 | Orphan claim re-pointed Claims processor | CLM-412101 → UHC-91457-63 (Ralph Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005556 | Orphan claim re-pointed Claims processor | CLM-422070 → UHC-12199-64 (Fatima Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005557 | Orphan claim re-pointed Claims processor | CLM-410418 → UHC-87446-96 (Kelly Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005558 | Orphan claim re-pointed Claims processor | CLM-403151 → UHC-95688-46 (Diego Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005559 | Orphan claim re-pointed Claims processor | CLM-427027 → UHC-89619-29 (Doris Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005560 | Orphan claim re-pointed Claims processor | CLM-403553 → UHC-39760-46 (Carolyn Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005561 | Orphan claim re-pointed Claims processor | CLM-402177 → UHC-92206-60 (Arthur Reynolds) |
| 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.