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-005862 | Orphan claim re-pointed Claims processor | CLM-403565 → UHC-64123-35 (Martha Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005863 | Orphan claim re-pointed Claims processor | CLM-417300 → UHC-34728-46 (Diego Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005864 | Orphan claim re-pointed Claims processor | CLM-409140 → UHC-27852-28 (Kelly Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005865 | Orphan claim re-pointed Claims processor | CLM-410735 → UHC-21146-73 (Christian Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005866 | Orphan claim re-pointed Claims processor | CLM-427913 → UHC-01972-71 (Denise Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005867 | Orphan claim re-pointed Claims processor | CLM-426433 → UHC-60488-61 (Jennfier Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005868 | Orphan claim re-pointed Claims processor | CLM-413858 → UHC-35192-79 (Justin Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005869 | Orphan claim re-pointed Claims processor | CLM-415347 → UHC-43459-75 (Margaret Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005870 | Orphan claim re-pointed Claims processor | CLM-430780 → UHC-14819-53 (Rebecca Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005871 | Orphan claim re-pointed Claims processor | CLM-400254 → UHC-21741-37 (Henry Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005872 | Orphan claim re-pointed Claims processor | CLM-420238 → UHC-80935-14 (Katherine Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005873 | Orphan claim re-pointed Claims processor | CLM-401835 → UHC-69471-08 (Cynthia Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005874 | Orphan claim re-pointed Claims processor | CLM-405670 → UHC-82913-21 (Diego Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005875 | Orphan claim re-pointed Claims processor | CLM-426425 → UHC-56145-05 (Amandda Webre) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005876 | Orphan claim re-pointed Claims processor | CLM-412747 → UHC-33244-23 (Nicole Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005877 | Orphan claim re-pointed Claims processor | CLM-413848 → UHC-30106-17 (Evelyn Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005878 | Orphan claim re-pointed Claims processor | CLM-430832 → UHC-52083-96 (Jesse Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005879 | Orphan claim re-pointed Claims processor | CLM-414243 → UHC-15395-10 (Jessica Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005880 | Orphan claim re-pointed Claims processor | CLM-420119 → UHC-51797-42 (Steven Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005881 | Orphan claim re-pointed Claims processor | CLM-405603 → UHC-31863-51 (Raymond Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005882 | Orphan claim re-pointed Claims processor | CLM-429265 → UHC-49834-84 (Terry Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005883 | Orphan claim re-pointed Claims processor | CLM-427763 → UHC-67198-90 (David Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005884 | Orphan claim re-pointed Claims processor | CLM-422301 → UHC-28465-51 (Kimberly Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005885 | Orphan claim re-pointed Claims processor | CLM-418483 → UHC-78489-07 (Yuki Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005886 | Orphan claim re-pointed Claims processor | CLM-410627 → UHC-86329-70 (Cynthia Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005887 | Orphan claim re-pointed Claims processor | CLM-419081 → UHC-49124-60 (Margaret Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005888 | Orphan claim re-pointed Claims processor | CLM-402270 → UHC-83618-98 (Camila Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005889 | Orphan claim re-pointed Claims processor | CLM-413247 → UHC-30977-89 (Kimberly Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005890 | Orphan claim re-pointed Claims processor | CLM-421871 → UHC-87776-07 (Mari Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005891 | Orphan claim re-pointed Claims processor | CLM-416485 → UHC-64249-21 (Martha Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005892 | Orphan claim re-pointed Claims processor | CLM-427894 → UHC-95721-09 (Aaron Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005893 | Orphan claim re-pointed Claims processor | CLM-419820 → UHC-35066-30 (Nicholas Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005894 | Orphan claim re-pointed Claims processor | CLM-415540 → UHC-50444-71 (Kenneth Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005895 | Orphan claim re-pointed Claims processor | CLM-425020 → UHC-83756-69 (Jerry Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005896 | Orphan claim re-pointed Claims processor | CLM-402862 → UHC-53509-18 (Jason White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005897 | Orphan claim re-pointed Claims processor | CLM-421640 → UHC-74387-24 (Janet Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005898 | Orphan claim re-pointed Claims processor | CLM-417774 → UHC-42386-79 (Patricia Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005899 | Orphan claim re-pointed Claims processor | CLM-417625 → UHC-33386-33 (Keith Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005900 | Orphan claim re-pointed Claims processor | CLM-411886 → UHC-85455-92 (Pamela Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005901 | Orphan claim re-pointed Claims processor | CLM-430885 → UHC-24395-12 (Priya Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005902 | Orphan claim re-pointed Claims processor | CLM-415359 → UHC-19167-90 (Bobby Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005903 | Orphan claim re-pointed Claims processor | CLM-422237 → UHC-26322-25 (Joseph Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005904 | Orphan claim re-pointed Claims processor | CLM-410493 → UHC-08616-48 (Maria Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005905 | Orphan claim re-pointed Claims processor | CLM-410628 → UHC-08656-71 (Ronald Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005906 | Orphan claim re-pointed Claims processor | CLM-405492 → UHC-27595-69 (Theresa Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005907 | Orphan claim re-pointed Claims processor | CLM-415029 → UHC-11917-91 (Lori Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005908 | Orphan claim re-pointed Claims processor | CLM-418503 → UHC-77781-56 (Ralph Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005909 | Orphan claim re-pointed Claims processor | CLM-417550 → UHC-76647-45 (Janice Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005910 | Orphan claim re-pointed Claims processor | CLM-427226 → UHC-15972-91 (Kimberly Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005911 | Orphan claim re-pointed Claims processor | CLM-424348 → UHC-51683-44 (Teresa 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.