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-005812 | Orphan claim re-pointed Claims processor | CLM-423458 → UHC-15734-55 (Patricia Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005813 | Orphan claim re-pointed Claims processor | CLM-423803 → UHC-46530-32 (Frank Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005814 | Orphan claim re-pointed Claims processor | CLM-401267 → UHC-49602-83 (Diego Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005815 | Orphan claim re-pointed Claims processor | CLM-404824 → UHC-23811-98 (Heather Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005816 | Orphan claim re-pointed Claims processor | CLM-421054 → UHC-98893-34 (Dennis Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005817 | Orphan claim re-pointed Claims processor | CLM-416338 → UHC-88907-28 (Albert Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005818 | Orphan claim re-pointed Claims processor | CLM-425167 → UHC-83435-92 (Randy Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005819 | Orphan claim re-pointed Claims processor | CLM-424062 → UHC-10104-58 (Luis Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005820 | Orphan claim re-pointed Claims processor | CLM-405498 → UHC-12383-43 (Ahmed Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005821 | Orphan claim re-pointed Claims processor | CLM-416444 → UHC-65456-50 (Janice Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005822 | Orphan claim re-pointed Claims processor | CLM-403334 → UHC-94792-89 (Janice Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005823 | Orphan claim re-pointed Claims processor | CLM-427416 → UHC-09454-42 (Karen Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005824 | Orphan claim re-pointed Claims processor | CLM-425161 → UHC-75033-63 (Joseph Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005825 | Orphan claim re-pointed Claims processor | CLM-409536 → UHC-14006-97 (Arjun Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005826 | Orphan claim re-pointed Claims processor | CLM-400190 → UHC-85133-36 (Jean Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005827 | Orphan claim re-pointed Claims processor | CLM-406899 → UHC-41769-76 (Barbara Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005828 | Orphan claim re-pointed Claims processor | CLM-420643 → UHC-67055-10 (Sarah Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005829 | Orphan claim re-pointed Claims processor | CLM-411294 → UHC-38480-02 (Kathryn Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005830 | Orphan claim re-pointed Claims processor | CLM-404940 → UHC-23727-64 (Zachary Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005831 | Orphan claim re-pointed Claims processor | CLM-407138 → UHC-72667-92 (Jason Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005832 | Orphan claim re-pointed Claims processor | CLM-419583 → UHC-23309-57 (Jesse Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005833 | Orphan claim re-pointed Claims processor | CLM-426884 → UHC-10651-17 (Doris Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005834 | Orphan claim re-pointed Claims processor | CLM-400990 → UHC-79174-43 (Amber Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005835 | Orphan claim re-pointed Claims processor | CLM-415703 → UHC-25722-63 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005836 | Orphan claim re-pointed Claims processor | CLM-403153 → UHC-72060-79 (Patrick Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005837 | Orphan claim re-pointed Claims processor | CLM-431702 → UHC-71837-12 (Samuel Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005838 | Orphan claim re-pointed Claims processor | CLM-418546 → UHC-49440-91 (Jean Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005839 | Orphan claim re-pointed Claims processor | CLM-411341 → UHC-35061-76 (Billy Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005840 | Orphan claim re-pointed Claims processor | CLM-400281 → UHC-00473-04 (Madison Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005841 | Orphan claim re-pointed Claims processor | CLM-413279 → UHC-14067-97 (Abigail Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005842 | Orphan claim re-pointed Claims processor | CLM-421380 → UHC-64036-10 (Alexis Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005843 | Orphan claim re-pointed Claims processor | CLM-429869 → UHC-72120-49 (Austin Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005844 | Orphan claim re-pointed Claims processor | CLM-424128 → UHC-90970-56 (Justni Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005845 | Orphan claim re-pointed Claims processor | CLM-428937 → UHC-54715-07 (Camila Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005846 | Orphan claim re-pointed Claims processor | CLM-414082 → UHC-96632-86 (James Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005847 | Orphan claim re-pointed Claims processor | CLM-428036 → UHC-47330-63 (Doris Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005848 | Orphan claim re-pointed Claims processor | CLM-423719 → UHC-82582-51 (Diane Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005849 | Orphan claim re-pointed Claims processor | CLM-415802 → UHC-77710-35 (Brian Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005850 | Orphan claim re-pointed Claims processor | CLM-412509 → UHC-84016-21 (Carlos Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005851 | Orphan claim re-pointed Claims processor | CLM-412312 → UHC-90814-20 (Barbara Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005852 | Orphan claim re-pointed Claims processor | CLM-415932 → UHC-24604-43 (Tony Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005853 | Orphan claim re-pointed Claims processor | CLM-409285 → UHC-53823-26 (Sandra Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005854 | Orphan claim re-pointed Claims processor | CLM-428811 → UHC-13247-56 (Dylan Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005855 | Orphan claim re-pointed Claims processor | CLM-403045 → UHC-44063-25 (Brittany Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005856 | Orphan claim re-pointed Claims processor | CLM-412847 → UHC-98312-99 (Jerry Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005857 | Orphan claim re-pointed Claims processor | CLM-427466 → UHC-46144-67 (Bryan Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005858 | Orphan claim re-pointed Claims processor | CLM-430975 → UHC-90564-84 (Diane Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005859 | Orphan claim re-pointed Claims processor | CLM-430274 → UHC-12731-65 (Sofia McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005860 | Orphan claim re-pointed Claims processor | CLM-431609 → UHC-75026-55 (Carolyn Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005861 | Orphan claim re-pointed Claims processor | CLM-429269 → UHC-12979-32 (Amanda Day) |
| 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.