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-005562 | Orphan claim re-pointed Claims processor | CLM-421682 → UHC-66335-80 (Gabriel Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005563 | Orphan claim re-pointed Claims processor | CLM-419812 → UHC-76634-70 (Margaret Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005564 | Orphan claim re-pointed Claims processor | CLM-418554 → UHC-31222-94 (Sara Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005565 | Orphan claim re-pointed Claims processor | CLM-422913 → UHC-01587-52 (Kayla Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005566 | Orphan claim re-pointed Claims processor | CLM-432626 → UHC-92029-25 (Edwrd Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005567 | Orphan claim re-pointed Claims processor | CLM-404095 → UHC-08725-60 (Joshua Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005568 | Orphan claim re-pointed Claims processor | CLM-406513 → UHC-58654-72 (Virginia Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005569 | Orphan claim re-pointed Claims processor | CLM-423172 → UHC-79845-73 (Kenneth James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005570 | Orphan claim re-pointed Claims processor | CLM-427625 → UHC-82292-56 (Lori Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005571 | Orphan claim re-pointed Claims processor | CLM-425596 → UHC-59041-99 (Aisha Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005572 | Orphan claim re-pointed Claims processor | CLM-423984 → UHC-96985-70 (Roger Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005573 | Orphan claim re-pointed Claims processor | CLM-408639 → UHC-41485-25 (Ana Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005574 | Orphan claim re-pointed Claims processor | CLM-432165 → UHC-72535-35 (Rachel Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005575 | Orphan claim re-pointed Claims processor | CLM-423665 → UHC-81252-69 (Janice Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005576 | Orphan claim re-pointed Claims processor | CLM-431435 → UHC-59072-43 (Susan Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005577 | Orphan claim re-pointed Claims processor | CLM-427968 → UHC-23075-63 (Benjamin Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005578 | Orphan claim re-pointed Claims processor | CLM-418652 → UHC-31898-22 (Carol Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005579 | Orphan claim re-pointed Claims processor | CLM-417745 → UHC-25388-31 (Ruth Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005580 | Orphan claim re-pointed Claims processor | CLM-408062 → UHC-99058-30 (Bruce Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005581 | Orphan claim re-pointed Claims processor | CLM-424262 → UHC-02642-89 (Lawrence Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005582 | Orphan claim re-pointed Claims processor | CLM-415416 → UHC-33879-78 (Bryan Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005583 | Orphan claim re-pointed Claims processor | CLM-413777 → UHC-93074-15 (Elizabeth Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005584 | Orphan claim re-pointed Claims processor | CLM-417608 → UHC-77256-81 (Ashley Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005585 | Orphan claim re-pointed Claims processor | CLM-400601 → UHC-32791-08 (Lisa Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005586 | Orphan claim re-pointed Claims processor | CLM-409238 → UHC-48373-74 (Maria Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005587 | Orphan claim re-pointed Claims processor | CLM-409519 → UHC-18692-03 (Hiroshi Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005588 | Orphan claim re-pointed Claims processor | CLM-400405 → UHC-06862-81 (Aaron Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005589 | Orphan claim re-pointed Claims processor | CLM-400275 → UHC-92974-96 (Alexander Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005590 | Orphan claim re-pointed Claims processor | CLM-428684 → UHC-74418-07 (Maria Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005591 | Orphan claim re-pointed Claims processor | CLM-432086 → UHC-74349-97 (Arthur Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005592 | Orphan claim re-pointed Claims processor | CLM-400919 → UHC-61532-06 (Catherine Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005593 | Orphan claim re-pointed Claims processor | CLM-410914 → UHC-70981-11 (Diana Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005594 | Orphan claim re-pointed Claims processor | CLM-427436 → UHC-79164-92 (Julie Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005595 | Orphan claim re-pointed Claims processor | CLM-408309 → UHC-92954-99 (Christine Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005596 | Orphan claim re-pointed Claims processor | CLM-415213 → UHC-11141-74 (Lucia Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005597 | Orphan claim re-pointed Claims processor | CLM-415576 → UHC-18628-86 (Barbara Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005598 | Orphan claim re-pointed Claims processor | CLM-400914 → UHC-81585-75 (Gloria Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005599 | Orphan claim re-pointed Claims processor | CLM-403884 → UHC-94244-68 (Keith Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005600 | Orphan claim re-pointed Claims processor | CLM-429534 → UHC-79482-59 (Betty Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005601 | Orphan claim re-pointed Claims processor | CLM-407992 → UHC-31120-14 (Samantha Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005602 | Orphan claim re-pointed Claims processor | CLM-431014 → UHC-39944-48 (Omar James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005603 | Orphan claim re-pointed Claims processor | CLM-428715 → UHC-71567-41 (Frances Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005604 | Orphan claim re-pointed Claims processor | CLM-422916 → UHC-41100-42 (Justin Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005605 | Orphan claim re-pointed Claims processor | CLM-426911 → UHC-92801-47 (Susan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005606 | Orphan claim re-pointed Claims processor | CLM-418550 → UHC-73379-98 (Russell Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005607 | Orphan claim re-pointed Claims processor | CLM-419431 → UHC-87437-98 (Christine Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005608 | Orphan claim re-pointed Claims processor | CLM-423240 → UHC-15009-91 (Jackie Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005609 | Orphan claim re-pointed Claims processor | CLM-412005 → UHC-57532-94 (Julia Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005610 | Orphan claim re-pointed Claims processor | CLM-418549 → UHC-73379-98 (Russell Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005611 | Orphan claim re-pointed Claims processor | CLM-426380 → UHC-73892-28 (Anna Boyd) |
| 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.