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-006162 | Orphan claim re-pointed Claims processor | CLM-425569 → UHC-72694-61 (Peter Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006163 | Orphan claim re-pointed Claims processor | CLM-403040 → UHC-14388-64 (Amber Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006164 | Orphan claim re-pointed Claims processor | CLM-409870 → UHC-03136-08 (Adam Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006165 | Orphan claim re-pointed Claims processor | CLM-410366 → UHC-42460-12 (Edward Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006166 | Orphan claim re-pointed Claims processor | CLM-410011 → UHC-50913-71 (Cynthia Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006167 | Orphan claim re-pointed Claims processor | CLM-418046 → UHC-70128-75 (Joseph Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006168 | Orphan claim re-pointed Claims processor | CLM-426746 → UHC-40588-93 (Brenda Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006169 | Orphan claim re-pointed Claims processor | CLM-407188 → UHC-52970-96 (Linda Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006170 | Orphan claim re-pointed Claims processor | CLM-427864 → UHC-68305-08 (Jacqueline Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006171 | Orphan claim re-pointed Claims processor | CLM-424801 → UHC-28305-27 (Dennis Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006172 | Orphan claim re-pointed Claims processor | CLM-428430 → UHC-21433-81 (John Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006173 | Orphan claim re-pointed Claims processor | CLM-422563 → UHC-30535-48 (Dylan Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006174 | Orphan claim re-pointed Claims processor | CLM-409281 → UHC-94005-32 (Rachel Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006175 | Orphan claim re-pointed Claims processor | CLM-400550 → UHC-19081-16 (Amy Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006176 | Orphan claim re-pointed Claims processor | CLM-412189 → UHC-94061-26 (Mary Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006177 | Orphan claim re-pointed Claims processor | CLM-430366 → UHC-56559-86 (Andrea Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006178 | Orphan claim re-pointed Claims processor | CLM-411395 → UHC-64102-34 (Jacob Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006179 | Orphan claim re-pointed Claims processor | CLM-405360 → UHC-12406-55 (Betty Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006180 | Orphan claim re-pointed Claims processor | CLM-405074 → UHC-63822-79 (Madison Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006181 | Orphan claim re-pointed Claims processor | CLM-416500 → UHC-43078-98 (Gary Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006182 | Orphan claim re-pointed Claims processor | CLM-409402 → UHC-69356-13 (Arjun Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006183 | Orphan claim re-pointed Claims processor | CLM-431957 → UHC-42973-31 (Danielle Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006184 | Orphan claim re-pointed Claims processor | CLM-412433 → UHC-71248-55 (Alice Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006185 | Orphan claim re-pointed Claims processor | CLM-411966 → UHC-91109-19 (Megan Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006186 | Orphan claim re-pointed Claims processor | CLM-425935 → UHC-64578-92 (Brenda Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006187 | Orphan claim re-pointed Claims processor | CLM-411449 → UHC-68959-66 (Theresa Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006188 | Orphan claim re-pointed Claims processor | CLM-416752 → UHC-79202-96 (Danielle Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006189 | Orphan claim re-pointed Claims processor | CLM-424660 → UHC-16910-09 (Joyce Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006190 | Orphan claim re-pointed Claims processor | CLM-412161 → UHC-63588-98 (Deborah Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006191 | Orphan claim re-pointed Claims processor | CLM-424717 → UHC-33688-95 (Tyler Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006192 | Orphan claim re-pointed Claims processor | CLM-413429 → UHC-31656-92 (Gabriel Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006193 | Orphan claim re-pointed Claims processor | CLM-429674 → UHC-32037-03 (Rachel Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006194 | Orphan claim re-pointed Claims processor | CLM-425944 → UHC-55654-50 (Donald Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006195 | Orphan claim re-pointed Claims processor | CLM-406982 → UHC-00239-37 (Mary Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006196 | Orphan claim re-pointed Claims processor | CLM-430565 → UHC-34472-84 (Logan Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006197 | Orphan claim re-pointed Claims processor | CLM-409944 → UHC-74053-63 (Gerald Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006198 | Orphan claim re-pointed Claims processor | CLM-421153 → UHC-34357-45 (Scott Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006199 | Orphan claim re-pointed Claims processor | CLM-418946 → UHC-72154-88 (Patrick Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006200 | Orphan claim re-pointed Claims processor | CLM-413143 → UHC-20494-29 (Christina Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006201 | Orphan claim re-pointed Claims processor | CLM-412725 → UHC-96949-18 (Ann Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006202 | Orphan claim re-pointed Claims processor | CLM-419320 → UHC-42042-21 (Diane Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006203 | Orphan claim re-pointed Claims processor | CLM-400954 → UHC-31286-37 (Camila Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006204 | Orphan claim re-pointed Claims processor | CLM-406891 → UHC-48815-83 (Albert Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006205 | Orphan claim re-pointed Claims processor | CLM-409980 → UHC-64251-76 (Jack Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006206 | Orphan claim re-pointed Claims processor | CLM-430543 → UHC-80172-58 (Lauren Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006207 | Orphan claim re-pointed Claims processor | CLM-421454 → UHC-93320-87 (Bruce Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006208 | Orphan claim re-pointed Claims processor | CLM-414618 → UHC-42338-82 (Cynthia Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006209 | Orphan claim re-pointed Claims processor | CLM-405632 → UHC-80846-56 (Bruce Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006210 | Orphan claim re-pointed Claims processor | CLM-417823 → UHC-37451-74 (Larry Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006211 | Orphan claim re-pointed Claims processor | CLM-406743 → UHC-46016-18 (Gloria Stone) |
| 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.