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-005612 | Orphan claim re-pointed Claims processor | CLM-418029 → UHC-76486-86 (Katherine Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005613 | Orphan claim re-pointed Claims processor | CLM-422344 → UHC-22273-83 (Martha Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005614 | Orphan claim re-pointed Claims processor | CLM-410710 → UHC-96663-83 (Evelyn Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005615 | Orphan claim re-pointed Claims processor | CLM-402623 → UHC-18828-56 (Luis Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005616 | Orphan claim re-pointed Claims processor | CLM-430051 → UHC-89611-35 (Gary Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005617 | Orphan claim re-pointed Claims processor | CLM-416166 → UHC-35992-83 (Tyler Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005618 | Orphan claim re-pointed Claims processor | CLM-429284 → UHC-41583-48 (Vincent Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005619 | Orphan claim re-pointed Claims processor | CLM-407074 → UHC-47771-45 (Angela Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005620 | Orphan claim re-pointed Claims processor | CLM-416569 → UHC-54398-04 (Julia Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005621 | Orphan claim re-pointed Claims processor | CLM-428519 → UHC-35911-04 (Carolyn Log) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005622 | Orphan claim re-pointed Claims processor | CLM-412389 → UHC-11519-51 (Linda Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005623 | Orphan claim re-pointed Claims processor | CLM-416482 → UHC-72382-09 (Arthur Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005624 | Orphan claim re-pointed Claims processor | CLM-417805 → UHC-54869-17 (Sean Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005625 | Orphan claim re-pointed Claims processor | CLM-403823 → UHC-84890-95 (Gerald Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005626 | Orphan claim re-pointed Claims processor | CLM-404097 → UHC-08426-20 (Alexander Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005627 | Orphan claim re-pointed Claims processor | CLM-405703 → UHC-77190-83 (Abigail Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005628 | Orphan claim re-pointed Claims processor | CLM-407478 → UHC-91231-49 (Andrew Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005629 | Orphan claim re-pointed Claims processor | CLM-402605 → UHC-15944-44 (Frances Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005630 | Orphan claim re-pointed Claims processor | CLM-403239 → UHC-56934-35 (Valentina Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005631 | Orphan claim re-pointed Claims processor | CLM-424597 → UHC-57735-93 (Jerry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005632 | Orphan claim re-pointed Claims processor | CLM-429666 → UHC-33762-69 (Jack Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005633 | Orphan claim re-pointed Claims processor | CLM-407260 → UHC-44419-60 (Lucia Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005634 | Orphan claim re-pointed Claims processor | CLM-421539 → UHC-53327-52 (Frances Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005635 | Orphan claim re-pointed Claims processor | CLM-400070 → UHC-31236-97 (Amber Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005636 | Orphan claim re-pointed Claims processor | CLM-410442 → UHC-84531-10 (Amy Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005637 | Orphan claim re-pointed Claims processor | CLM-408344 → UHC-58073-33 (Alexander Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005638 | Orphan claim re-pointed Claims processor | CLM-411892 → UHC-60653-85 (Ryan Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005639 | Orphan claim re-pointed Claims processor | CLM-419065 → UHC-32667-67 (Emma Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005640 | Orphan claim re-pointed Claims processor | CLM-403306 → UHC-59675-28 (Hannah Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005641 | Orphan claim re-pointed Claims processor | CLM-422158 → UHC-77209-51 (Steven Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005642 | Orphan claim re-pointed Claims processor | CLM-422254 → UHC-83369-97 (Bobby Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005643 | Orphan claim re-pointed Claims processor | CLM-431100 → UHC-46389-21 (Kimberly Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005644 | Orphan claim re-pointed Claims processor | CLM-404335 → UHC-24935-31 (Daniel Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005645 | Orphan claim re-pointed Claims processor | CLM-414401 → UHC-25825-42 (Danielle Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005646 | Orphan claim re-pointed Claims processor | CLM-431198 → UHC-14479-29 (Wayne Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005647 | Orphan claim re-pointed Claims processor | CLM-432665 → UHC-52129-98 (Zachary Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005648 | Orphan claim re-pointed Claims processor | CLM-428459 → UHC-50518-63 (Martha Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005649 | Orphan claim re-pointed Claims processor | CLM-400113 → UHC-87640-10 (Joseph Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005650 | Orphan claim re-pointed Claims processor | CLM-401614 → UHC-37758-70 (Ralph Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005651 | Orphan claim re-pointed Claims processor | CLM-411217 → UHC-90335-73 (Victoria Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005652 | Orphan claim re-pointed Claims processor | CLM-423156 → UHC-06309-97 (Natalie Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005653 | Orphan claim re-pointed Claims processor | CLM-416862 → UHC-21154-82 (David Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005654 | Orphan claim re-pointed Claims processor | CLM-405766 → UHC-63658-24 (Ralph Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005655 | Orphan claim re-pointed Claims processor | CLM-408782 → UHC-11581-57 (Russell Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005656 | Orphan claim re-pointed Claims processor | CLM-430794 → UHC-87523-64 (Brittany Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005657 | Orphan claim re-pointed Claims processor | CLM-402373 → UHC-24160-93 (Matthew Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005658 | Orphan claim re-pointed Claims processor | CLM-400345 → UHC-94513-70 (Eugene Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005659 | Orphan claim re-pointed Claims processor | CLM-410343 → UHC-31741-46 (Megan Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005660 | Orphan claim re-pointed Claims processor | CLM-430567 → UHC-53365-30 (Diane Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005661 | Orphan claim re-pointed Claims processor | CLM-430048 → UHC-24100-19 (Martha Powell) |
| 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.