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-005662 | Orphan claim re-pointed Claims processor | CLM-406545 → UHC-97825-92 (Brian Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005663 | Orphan claim re-pointed Claims processor | CLM-418291 → UHC-49860-99 (Margaret Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005664 | Orphan claim re-pointed Claims processor | CLM-406610 → UHC-64413-52 (Sophia Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005665 | Orphan claim re-pointed Claims processor | CLM-401691 → UHC-65220-77 (Daniel Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005666 | Orphan claim re-pointed Claims processor | CLM-430285 → UHC-25449-95 (Deborah Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005667 | Orphan claim re-pointed Claims processor | CLM-411738 → UHC-25309-64 (Janet Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005668 | Orphan claim re-pointed Claims processor | CLM-419071 → UHC-35369-94 (Timothy Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005669 | Orphan claim re-pointed Claims processor | CLM-417726 → UHC-36471-89 (Logan Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005670 | Orphan claim re-pointed Claims processor | CLM-423475 → UHC-10004-82 (Walter Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005671 | Orphan claim re-pointed Claims processor | CLM-407578 → UHC-91479-96 (Steven McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005672 | Orphan claim re-pointed Claims processor | CLM-417201 → UHC-33529-32 (Marilyn Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005673 | Orphan claim re-pointed Claims processor | CLM-430521 → UHC-49979-38 (Ronald Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005674 | Orphan claim re-pointed Claims processor | CLM-423153 → UHC-66125-48 (Matthew Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005675 | Orphan claim re-pointed Claims processor | CLM-402823 → UHC-59591-67 (Kimberly Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005676 | Orphan claim re-pointed Claims processor | CLM-415503 → UHC-79204-52 (Ryan Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005677 | Orphan claim re-pointed Claims processor | CLM-430732 → UHC-04129-68 (Sharon Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005678 | Orphan claim re-pointed Claims processor | CLM-402647 → UHC-95138-15 (Wayne McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005679 | Orphan claim re-pointed Claims processor | CLM-417072 → UHC-77656-36 (Dennis Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005680 | Orphan claim re-pointed Claims processor | CLM-431125 → UHC-75752-29 (Philip Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005681 | Orphan claim re-pointed Claims processor | CLM-428212 → UHC-43401-37 (Carl Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005682 | Orphan claim re-pointed Claims processor | CLM-419871 → UHC-11034-93 (Sofia Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005683 | Orphan claim re-pointed Claims processor | CLM-418055 → UHC-48865-86 (Karen Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005684 | Orphan claim re-pointed Claims processor | CLM-400153 → UHC-50573-60 (Joseph Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005685 | Orphan claim re-pointed Claims processor | CLM-424912 → UHC-19333-94 (Isabella Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005686 | Orphan claim re-pointed Claims processor | CLM-415043 → UHC-52374-70 (Mei Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005687 | Orphan claim re-pointed Claims processor | CLM-420371 → UHC-78892-70 (Gabriel Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005688 | Orphan claim re-pointed Claims processor | CLM-428611 → UHC-10284-93 (Shirley Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005689 | Orphan claim re-pointed Claims processor | CLM-400266 → UHC-52389-49 (Charlotte Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005690 | Orphan claim re-pointed Claims processor | CLM-405180 → UHC-97377-90 (Marilyn Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005691 | Orphan claim re-pointed Claims processor | CLM-418880 → UHC-85876-46 (Austin Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005692 | Orphan claim re-pointed Claims processor | CLM-428023 → UHC-43990-46 (Sharon Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005693 | Orphan claim re-pointed Claims processor | CLM-409111 → UHC-38123-88 (Zachary Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005694 | Orphan claim re-pointed Claims processor | CLM-425411 → UHC-57483-84 (Frances Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005695 | Orphan claim re-pointed Claims processor | CLM-412870 → UHC-46507-42 (Nancy Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005696 | Orphan claim re-pointed Claims processor | CLM-428959 → UHC-70161-33 (Robert Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005697 | Orphan claim re-pointed Claims processor | CLM-420096 → UHC-19295-48 (Hiroshi Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005698 | Orphan claim re-pointed Claims processor | CLM-408284 → UHC-78528-57 (Betty Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005699 | Orphan claim re-pointed Claims processor | CLM-419787 → UHC-50265-96 (Kvein Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005700 | Orphan claim re-pointed Claims processor | CLM-428203 → UHC-31520-38 (Lawrence Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005701 | Orphan claim re-pointed Claims processor | CLM-429572 → UHC-15588-86 (Jonathan Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005702 | Orphan claim re-pointed Claims processor | CLM-423455 → UHC-87978-96 (Diego Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005703 | Orphan claim re-pointed Claims processor | CLM-417200 → UHC-16937-14 (Russell Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005704 | Orphan claim re-pointed Claims processor | CLM-429927 → UHC-87847-39 (Shirley Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005705 | Orphan claim re-pointed Claims processor | CLM-412803 → UHC-18255-97 (Wei Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005706 | Orphan claim re-pointed Claims processor | CLM-429456 → UHC-79343-17 (Jose Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005707 | Orphan claim re-pointed Claims processor | CLM-425809 → UHC-44852-79 (Gary Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005708 | Orphan claim re-pointed Claims processor | CLM-415907 → UHC-91345-99 (Alexis Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005709 | Orphan claim re-pointed Claims processor | CLM-409827 → UHC-87084-73 (Melissa Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005710 | Orphan claim re-pointed Claims processor | CLM-400594 → UHC-76560-14 (Harold West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005711 | Orphan claim re-pointed Claims processor | CLM-424546 → UHC-45944-04 (Michael Gutierrez) |
| 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.