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-006062 | Orphan claim re-pointed Claims processor | CLM-429352 → UHC-55421-50 (Jeremy Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006063 | Orphan claim re-pointed Claims processor | CLM-403811 → UHC-44326-19 (Willie Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006064 | Orphan claim re-pointed Claims processor | CLM-422675 → UHC-62501-64 (Wei Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006065 | Orphan claim re-pointed Claims processor | CLM-416497 → UHC-35385-80 (Aisha Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006066 | Orphan claim re-pointed Claims processor | CLM-410251 → UHC-83567-23 (David Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006067 | Orphan claim re-pointed Claims processor | CLM-431843 → UHC-72484-78 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006068 | Orphan claim re-pointed Claims processor | CLM-416313 → UHC-78882-41 (Kathleen Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006069 | Orphan claim re-pointed Claims processor | CLM-419357 → UHC-07141-01 (Wei Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006070 | Orphan claim re-pointed Claims processor | CLM-427546 → UHC-33142-39 (Joe Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006071 | Orphan claim re-pointed Claims processor | CLM-418489 → UHC-55488-72 (Bruce Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006072 | Orphan claim re-pointed Claims processor | CLM-430776 → UHC-10883-60 (Carol Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006073 | Orphan claim re-pointed Claims processor | CLM-401563 → UHC-90730-92 (Richard Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006074 | Orphan claim re-pointed Claims processor | CLM-410939 → UHC-38545-58 (Ronald Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006075 | Orphan claim re-pointed Claims processor | CLM-401246 → UHC-50329-53 (Aisha Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006076 | Orphan claim re-pointed Claims processor | CLM-429493 → UHC-27024-93 (Janet Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006077 | Orphan claim re-pointed Claims processor | CLM-424022 → UHC-58273-21 (Mike Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006078 | Orphan claim re-pointed Claims processor | CLM-431552 → UHC-73170-37 (Rebecca Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006079 | Orphan claim re-pointed Claims processor | CLM-422903 → UHC-34570-63 (Mary Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006080 | Orphan claim re-pointed Claims processor | CLM-430313 → UHC-32544-49 (Sofia Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006081 | Orphan claim re-pointed Claims processor | CLM-411914 → UHC-68631-94 (Hannah Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006082 | Orphan claim re-pointed Claims processor | CLM-408614 → UHC-25349-55 (Ralph Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006083 | Orphan claim re-pointed Claims processor | CLM-418697 → UHC-36004-77 (George Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006084 | Orphan claim re-pointed Claims processor | CLM-423004 → UHC-72599-06 (Julia Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006085 | Orphan claim re-pointed Claims processor | CLM-402246 → UHC-09052-71 (Nathan Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006086 | Orphan claim re-pointed Claims processor | CLM-400045 → UHC-49836-32 (Maria McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006087 | Orphan claim re-pointed Claims processor | CLM-417680 → UHC-72304-99 (Kevin Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006088 | Orphan claim re-pointed Claims processor | CLM-414983 → UHC-50017-78 (Henry Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006089 | Orphan claim re-pointed Claims processor | CLM-411642 → UHC-63648-05 (Hiroshi Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006090 | Orphan claim re-pointed Claims processor | CLM-416123 → UHC-97348-98 (Carl Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006091 | Orphan claim re-pointed Claims processor | CLM-414765 → UHC-12484-48 (Benjamin Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006092 | Orphan claim re-pointed Claims processor | CLM-425608 → UHC-84542-04 (Nicole Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006093 | Orphan claim re-pointed Claims processor | CLM-419179 → UHC-54196-42 (Gerald Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006094 | Orphan claim re-pointed Claims processor | CLM-421808 → UHC-07105-17 (Tyler Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006095 | Orphan claim re-pointed Claims processor | CLM-402492 → UHC-38178-59 (Danielle Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006096 | Orphan claim re-pointed Claims processor | CLM-417899 → UHC-09556-36 (Elizabeth Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006097 | Orphan claim re-pointed Claims processor | CLM-411521 → UHC-02014-79 (Aigail Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006098 | Orphan claim re-pointed Claims processor | CLM-413694 → UHC-52339-28 (Jesse Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006099 | Orphan claim re-pointed Claims processor | CLM-421402 → UHC-96277-14 (Tyler Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006100 | Orphan claim re-pointed Claims processor | CLM-402359 → UHC-74681-79 (Philip Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006101 | Orphan claim re-pointed Claims processor | CLM-410835 → UHC-51902-38 (Albert Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006102 | Orphan claim re-pointed Claims processor | CLM-402886 → UHC-08276-88 (Mark Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006103 | Orphan claim re-pointed Claims processor | CLM-428734 → UHC-44059-63 (Mary Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006104 | Orphan claim re-pointed Claims processor | CLM-418505 → UHC-20425-50 (Emma Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006105 | Orphan claim re-pointed Claims processor | CLM-423107 → UHC-04176-72 (Raymond Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006106 | Orphan claim re-pointed Claims processor | CLM-408378 → UHC-10242-73 (Ralph Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006107 | Orphan claim re-pointed Claims processor | CLM-425595 → UHC-29702-93 (Adam Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006108 | Orphan claim re-pointed Claims processor | CLM-411482 → UHC-85426-75 (Madison White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006109 | Orphan claim re-pointed Claims processor | CLM-428932 → UHC-89238-83 (Theresa West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006110 | Orphan claim re-pointed Claims processor | CLM-406600 → UHC-82645-48 (Douglas Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006111 | Orphan claim re-pointed Claims processor | CLM-427345 → UHC-40250-67 (Scott Boyd) |
| 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.