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-005962 | Orphan claim re-pointed Claims processor | CLM-409344 → UHC-22188-38 (Anthony Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005963 | Orphan claim re-pointed Claims processor | CLM-401025 → UHC-89960-59 (Maria Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005964 | Orphan claim re-pointed Claims processor | CLM-401192 → UHC-05445-31 (Dennis Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005965 | Orphan claim re-pointed Claims processor | CLM-415545 → UHC-20729-69 (Andrew Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005966 | Orphan claim re-pointed Claims processor | CLM-410832 → UHC-52432-11 (Edward Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005967 | Orphan claim re-pointed Claims processor | CLM-414503 → UHC-26652-20 (Brandon Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005968 | Orphan claim re-pointed Claims processor | CLM-411258 → UHC-34912-78 (Jessica Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005969 | Orphan claim re-pointed Claims processor | CLM-400180 → UHC-95243-62 (Camila Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005970 | Orphan claim re-pointed Claims processor | CLM-415810 → UHC-93864-36 (Steven Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005971 | Orphan claim re-pointed Claims processor | CLM-419249 → UHC-73414-40 (Marcus Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005972 | Orphan claim re-pointed Claims processor | CLM-406753 → UHC-53525-01 (Gary Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005973 | Orphan claim re-pointed Claims processor | CLM-402024 → UHC-16733-85 (Elijah Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005974 | Orphan claim re-pointed Claims processor | CLM-429703 → UHC-09752-86 (Joshua Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005975 | Orphan claim re-pointed Claims processor | CLM-430791 → UHC-08546-06 (Cynthia Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005976 | Orphan claim re-pointed Claims processor | CLM-430577 → UHC-01568-37 (Arthur Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005977 | Orphan claim re-pointed Claims processor | CLM-412183 → UHC-00823-45 (Kathryn Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005978 | Orphan claim re-pointed Claims processor | CLM-400714 → UHC-78677-80 (Matt Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005979 | Orphan claim re-pointed Claims processor | CLM-421573 → UHC-84552-22 (Diego Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005980 | Orphan claim re-pointed Claims processor | CLM-420503 → UHC-14729-92 (Keith Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005981 | Orphan claim re-pointed Claims processor | CLM-431915 → UHC-57612-75 (Juan Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005982 | Orphan claim re-pointed Claims processor | CLM-416365 → UHC-95105-58 (Ruth Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005983 | Orphan claim re-pointed Claims processor | CLM-416553 → UHC-75701-22 (Keith Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005984 | Orphan claim re-pointed Claims processor | CLM-421462 → UHC-12228-04 (Juan Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005985 | Orphan claim re-pointed Claims processor | CLM-425329 → UHC-34873-58 (Amber Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005986 | Orphan claim re-pointed Claims processor | CLM-404464 → UHC-46738-13 (Bruce Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005987 | Orphan claim re-pointed Claims processor | CLM-415541 → UHC-50444-71 (Kenneth Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005988 | Orphan claim re-pointed Claims processor | CLM-408425 → UHC-02437-39 (Mark Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005989 | Orphan claim re-pointed Claims processor | CLM-400338 → UHC-15915-54 (Ralph Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005990 | Orphan claim re-pointed Claims processor | CLM-431773 → UHC-03440-99 (Arjun Reies) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005991 | Orphan claim re-pointed Claims processor | CLM-402579 → UHC-16722-55 (Teresa McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005992 | Orphan claim re-pointed Claims processor | CLM-408415 → UHC-47425-07 (James Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005993 | Orphan claim re-pointed Claims processor | CLM-430479 → UHC-43570-25 (Nicholas Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005994 | Orphan claim re-pointed Claims processor | CLM-404749 → UHC-78406-35 (Gabriel Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005995 | Orphan claim re-pointed Claims processor | CLM-415598 → UHC-41853-46 (Ruth Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005996 | Orphan claim re-pointed Claims processor | CLM-404433 → UHC-00221-37 (Scott Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005997 | Orphan claim re-pointed Claims processor | CLM-409396 → UHC-60400-11 (Susan Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005998 | Orphan claim re-pointed Claims processor | CLM-431208 → UHC-13043-98 (Samantha Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005999 | Orphan claim re-pointed Claims processor | CLM-419724 → UHC-64455-52 (Aisha Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006000 | Orphan claim re-pointed Claims processor | CLM-412526 → UHC-53297-26 (Jon Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006001 | Orphan claim re-pointed Claims processor | CLM-426768 → UHC-24354-61 (Virginia Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006002 | Orphan claim re-pointed Claims processor | CLM-418522 → UHC-87779-65 (Andrea Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006003 | Orphan claim re-pointed Claims processor | CLM-425085 → UHC-94738-62 (Steven Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006004 | Orphan claim re-pointed Claims processor | CLM-423995 → UHC-86250-15 (Karen Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006005 | Orphan claim re-pointed Claims processor | CLM-405157 → UHC-32649-36 (Alexis Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006006 | Orphan claim re-pointed Claims processor | CLM-414048 → UHC-76032-71 (Mason Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006007 | Orphan claim re-pointed Claims processor | CLM-409583 → UHC-53110-32 (Jennifer Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006008 | Orphan claim re-pointed Claims processor | CLM-404713 → UHC-84483-96 (Mary Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006009 | Orphan claim re-pointed Claims processor | CLM-427040 → UHC-75863-44 (Christina Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006010 | Orphan claim re-pointed Claims processor | CLM-423477 → UHC-70943-35 (Mariana Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006011 | Orphan claim re-pointed Claims processor | CLM-408193 → UHC-30933-70 (Larry Patterson) |
| 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.