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-005762 | Orphan claim re-pointed Claims processor | CLM-402527 → UHC-86194-82 (Joyce Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005763 | Orphan claim re-pointed Claims processor | CLM-404247 → UHC-14129-58 (Juhn Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005764 | Orphan claim re-pointed Claims processor | CLM-428953 → UHC-99604-61 (Susan Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005765 | Orphan claim re-pointed Claims processor | CLM-418186 → UHC-96996-81 (Jennifer Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005766 | Orphan claim re-pointed Claims processor | CLM-402805 → UHC-42263-40 (Bruce Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005767 | Orphan claim re-pointed Claims processor | CLM-412601 → UHC-10278-83 (Cheryl Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005768 | Orphan claim re-pointed Claims processor | CLM-407069 → UHC-40503-63 (Nathan Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005769 | Orphan claim re-pointed Claims processor | CLM-425052 → UHC-92395-20 (Charles Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005770 | Orphan claim re-pointed Claims processor | CLM-401869 → UHC-63167-30 (Nicholas Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005771 | Orphan claim re-pointed Claims processor | CLM-401489 → UHC-17206-25 (Marcus Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005772 | Orphan claim re-pointed Claims processor | CLM-408127 → UHC-30664-27 (Ralph Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005773 | Orphan claim re-pointed Claims processor | CLM-408650 → UHC-72503-97 (Jerry Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005774 | Orphan claim re-pointed Claims processor | CLM-427408 → UHC-46813-22 (Arun Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005775 | Orphan claim re-pointed Claims processor | CLM-424509 → UHC-98583-63 (Bruce Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005776 | Orphan claim re-pointed Claims processor | CLM-425801 → UHC-51264-75 (Scott Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005777 | Orphan claim re-pointed Claims processor | CLM-407179 → UHC-59277-27 (Kathlean Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005778 | Orphan claim re-pointed Claims processor | CLM-418234 → UHC-38273-80 (Eugene Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005779 | Orphan claim re-pointed Claims processor | CLM-409449 → UHC-97966-71 (Bobby Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005780 | Orphan claim re-pointed Claims processor | CLM-426324 → UHC-99703-83 (Gloria Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005781 | Orphan claim re-pointed Claims processor | CLM-422114 → UHC-73625-05 (Gloria Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005782 | Orphan claim re-pointed Claims processor | CLM-413249 → UHC-39910-13 (Susan Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005783 | Orphan claim re-pointed Claims processor | CLM-409117 → UHC-16620-48 (Mary Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005784 | Orphan claim re-pointed Claims processor | CLM-429784 → UHC-40362-42 (Vincent Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005785 | Orphan claim re-pointed Claims processor | CLM-405440 → UHC-62926-91 (Jesse Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005786 | Orphan claim re-pointed Claims processor | CLM-413031 → UHC-42291-53 (Brittany Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005787 | Orphan claim re-pointed Claims processor | CLM-429015 → UHC-46437-60 (Brenda Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005788 | Orphan claim re-pointed Claims processor | CLM-402595 → UHC-52002-05 (Patricia Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005789 | Orphan claim re-pointed Claims processor | CLM-427596 → UHC-06931-94 (Joe Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005790 | Orphan claim re-pointed Claims processor | CLM-431323 → UHC-46514-85 (Jack Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005791 | Orphan claim re-pointed Claims processor | CLM-409571 → UHC-33464-88 (Harold Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005792 | Orphan claim re-pointed Claims processor | CLM-412431 → UHC-41836-57 (Willie Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005793 | Orphan claim re-pointed Claims processor | CLM-403611 → UHC-10594-91 (Joseph Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005794 | Orphan claim re-pointed Claims processor | CLM-416142 → UHC-61680-99 (Karen Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005795 | Orphan claim re-pointed Claims processor | CLM-400237 → UHC-96990-15 (Angela Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005796 | Orphan claim re-pointed Claims processor | CLM-425893 → UHC-32653-89 (Maria Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005797 | Orphan claim re-pointed Claims processor | CLM-425717 → UHC-20504-81 (Teresa Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005798 | Orphan claim re-pointed Claims processor | CLM-427378 → UHC-30457-09 (Roger Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005799 | Orphan claim re-pointed Claims processor | CLM-405041 → UHC-78535-38 (Judy Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005800 | Orphan claim re-pointed Claims processor | CLM-401206 → UHC-20620-59 (Katherine Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005801 | Orphan claim re-pointed Claims processor | CLM-407617 → UHC-79313-90 (Patricia Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005802 | Orphan claim re-pointed Claims processor | CLM-412968 → UHC-20449-42 (Janice Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005803 | Orphan claim re-pointed Claims processor | CLM-401425 → UHC-69979-70 (Maria Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005804 | Orphan claim re-pointed Claims processor | CLM-410430 → UHC-36655-13 (Anna Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005805 | Orphan claim re-pointed Claims processor | CLM-429432 → UHC-83381-43 (Mason Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005806 | Orphan claim re-pointed Claims processor | CLM-419003 → UHC-78943-88 (Rachel Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005807 | Orphan claim re-pointed Claims processor | CLM-426478 → UHC-23750-61 (Bryan Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005808 | Orphan claim re-pointed Claims processor | CLM-411775 → UHC-64477-90 (Eric Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005809 | Orphan claim re-pointed Claims processor | CLM-402188 → UHC-07177-15 (Theresa West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005810 | Orphan claim re-pointed Claims processor | CLM-404895 → UHC-67650-36 (Wei Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005811 | Orphan claim re-pointed Claims processor | CLM-419704 → UHC-19883-88 (Gabriel Thompson) |
| 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.