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-002540 | Orphan claim re-pointed Claims processor | CLM-419471 → UHC-05418-33 (Kimberly Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002541 | Orphan claim re-pointed Claims processor | CLM-410484 → UHC-98537-14 (Carolyn Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002542 | Orphan claim re-pointed Claims processor | CLM-422125 → UHC-14764-41 (Donald Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002543 | Orphan claim re-pointed Claims processor | CLM-431865 → UHC-57256-57 (Lawrence Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002544 | Orphan claim re-pointed Claims processor | CLM-427330 → UHC-27163-89 (Alexander Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002545 | Orphan claim re-pointed Claims processor | CLM-421587 → UHC-56787-59 (Doris Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002546 | Orphan claim re-pointed Claims processor | CLM-428962 → UHC-48005-22 (Yuki Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002547 | Orphan claim re-pointed Claims processor | CLM-427497 → UHC-98629-39 (Logan Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002548 | Orphan claim re-pointed Claims processor | CLM-424389 → UHC-74662-82 (Sofia Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002549 | Orphan claim re-pointed Claims processor | CLM-404105 → UHC-74272-06 (Zachary Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002550 | Orphan claim re-pointed Claims processor | CLM-401313 → UHC-98286-73 (Ahmed Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002551 | Orphan claim re-pointed Claims processor | CLM-426268 → UHC-56034-71 (Bryan Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002552 | Orphan claim re-pointed Claims processor | CLM-411579 → UHC-76995-58 (Elijah Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002553 | Orphan claim re-pointed Claims processor | CLM-416066 → UHC-64534-54 (Jeffrey Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002554 | Orphan claim re-pointed Claims processor | CLM-415515 → UHC-43588-39 (Keith Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002555 | Orphan claim re-pointed Claims processor | CLM-426114 → UHC-85304-86 (James Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002556 | Orphan claim re-pointed Claims processor | CLM-430815 → UHC-56570-23 (Diego Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002557 | Orphan claim re-pointed Claims processor | CLM-429679 → UHC-60673-74 (Julie Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002558 | Orphan claim re-pointed Claims processor | CLM-403803 → UHC-96623-89 (Ryan Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002559 | Orphan claim re-pointed Claims processor | CLM-417291 → UHC-99756-43 (Jacob Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002560 | Orphan claim re-pointed Claims processor | CLM-422234 → UHC-27302-30 (Marilyn West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002561 | Orphan claim re-pointed Claims processor | CLM-419379 → UHC-85432-06 (Albert Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002562 | Orphan claim re-pointed Claims processor | CLM-424149 → UHC-12380-01 (Angela Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002563 | Orphan claim re-pointed Claims processor | CLM-415028 → UHC-11917-91 (Lori Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002564 | Orphan claim re-pointed Claims processor | CLM-424520 → UHC-65748-45 (Theresa Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002565 | Orphan claim re-pointed Claims processor | CLM-401706 → UHC-32789-96 (Linda Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002566 | Orphan claim re-pointed Claims processor | CLM-425786 → UHC-78142-72 (Danielle Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002567 | Orphan claim re-pointed Claims processor | CLM-427526 → UHC-80435-97 (Ann Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002568 | Orphan claim re-pointed Claims processor | CLM-406081 → UHC-61162-85 (George Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002569 | Orphan claim re-pointed Claims processor | CLM-430649 → UHC-22421-51 (Sharon Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002570 | Orphan claim re-pointed Claims processor | CLM-431543 → UHC-37191-05 (Patricia Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002571 | Orphan claim re-pointed Claims processor | CLM-415157 → UHC-07746-98 (Martha Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002572 | Orphan claim re-pointed Claims processor | CLM-416943 → UHC-53088-33 (Dorothy Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002573 | Orphan claim re-pointed Claims processor | CLM-418261 → UHC-73471-18 (Jonathan Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002574 | Orphan claim re-pointed Claims processor | CLM-423112 → UHC-01497-69 (Gloria Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002575 | Orphan claim re-pointed Claims processor | CLM-424390 → UHC-55213-66 (Jacqueline Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002576 | Orphan claim re-pointed Claims processor | CLM-430107 → UHC-50719-93 (Carlos Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002577 | Orphan claim re-pointed Claims processor | CLM-416103 → UHC-58764-26 (Edward Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002578 | Orphan claim re-pointed Claims processor | CLM-403207 → UHC-46795-50 (Betty Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002579 | Orphan claim re-pointed Claims processor | CLM-430775 → UHC-10883-60 (Carol Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002580 | Orphan claim re-pointed Claims processor | CLM-411644 → UHC-25176-33 (Adam Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002581 | Orphan claim re-pointed Claims processor | CLM-411207 → UHC-80098-32 (Helen Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002582 | Orphan claim re-pointed Claims processor | CLM-404246 → UHC-14129-58 (Juhn Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002583 | Orphan claim re-pointed Claims processor | CLM-425070 → UHC-85183-78 (Joan Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002584 | Orphan claim re-pointed Claims processor | CLM-422860 → UHC-54454-59 (Cynthia Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002585 | Orphan claim re-pointed Claims processor | CLM-431268 → UHC-15710-14 (Alice Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002586 | Orphan claim re-pointed Claims processor | CLM-421254 → UHC-04073-64 (Lisa Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002587 | Orphan claim re-pointed Claims processor | CLM-430499 → UHC-17326-17 (Albert Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002588 | Orphan claim re-pointed Claims processor | CLM-406453 → UHC-47380-81 (Brennda Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002589 | Orphan claim re-pointed Claims processor | CLM-414637 → UHC-71285-92 (Evelyn Hawkins) |
| 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.