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-006212 | Orphan claim re-pointed Claims processor | CLM-418201 → UHC-65814-20 (Deborah Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006213 | Orphan claim re-pointed Claims processor | CLM-427987 → UHC-18318-35 (George Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006214 | Orphan claim re-pointed Claims processor | CLM-409729 → UHC-44506-47 (Samantha Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006215 | Orphan claim re-pointed Claims processor | CLM-431040 → UHC-83521-36 (Anthony Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006216 | Orphan claim re-pointed Claims processor | CLM-406842 → UHC-44229-06 (Charles Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006217 | Orphan claim re-pointed Claims processor | CLM-419733 → UHC-30792-11 (Jennifer Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006218 | Orphan claim re-pointed Claims processor | CLM-409176 → UHC-03136-61 (Camila Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006219 | Orphan claim re-pointed Claims processor | CLM-400484 → UHC-16126-85 (Santiago Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006220 | Orphan claim re-pointed Claims processor | CLM-429952 → UHC-09608-97 (Danielle Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006221 | Orphan claim re-pointed Claims processor | CLM-416239 → UHC-07810-03 (Jeremy Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006222 | Orphan claim re-pointed Claims processor | CLM-416983 → UHC-34661-92 (Walter Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006223 | Orphan claim re-pointed Claims processor | CLM-419142 → UHC-55774-23 (Yuki Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006224 | Orphan claim re-pointed Claims processor | CLM-426623 → UHC-11062-05 (Tony Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006225 | Orphan claim re-pointed Claims processor | CLM-411386 → UHC-41662-03 (Nathan Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006226 | Orphan claim re-pointed Claims processor | CLM-417045 → UHC-99921-94 (Thomas Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006227 | Orphan claim re-pointed Claims processor | CLM-415798 → UHC-07594-37 (Joe Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006228 | Orphan claim re-pointed Claims processor | CLM-409949 → UHC-52082-68 (Ahmed West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006229 | Orphan claim re-pointed Claims processor | CLM-418851 → UHC-18708-72 (Douglas McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006230 | Orphan claim re-pointed Claims processor | CLM-406133 → UHC-24750-67 (Lori Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006231 | Orphan claim re-pointed Claims processor | CLM-418281 → UHC-54533-25 (Abigail Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006232 | Orphan claim re-pointed Claims processor | CLM-432012 → UHC-49736-25 (Doris Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006233 | Orphan claim re-pointed Claims processor | CLM-421037 → UHC-85134-32 (Evelyn Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006234 | Orphan claim re-pointed Claims processor | CLM-423780 → UHC-97733-79 (Gloria Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006235 | Orphan claim re-pointed Claims processor | CLM-415762 → UHC-91168-07 (Emily Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006236 | Orphan claim re-pointed Claims processor | CLM-420586 → UHC-27339-67 (Margaret Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006237 | Orphan claim re-pointed Claims processor | CLM-403079 → UHC-50013-23 (Roy Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006238 | Orphan claim re-pointed Claims processor | CLM-409439 → UHC-09336-70 (Emily Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006239 | Orphan claim re-pointed Claims processor | CLM-422801 → UHC-61797-78 (Kyle Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006240 | Orphan claim re-pointed Claims processor | CLM-432288 → UHC-75959-53 (Cheryl Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006241 | Orphan claim re-pointed Claims processor | CLM-419178 → UHC-95164-43 (Jordan Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006242 | Orphan claim re-pointed Claims processor | CLM-426969 → UHC-79906-78 (Delgado Christine) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006243 | Orphan claim re-pointed Claims processor | CLM-429154 → UHC-03491-04 (Anna Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006244 | Orphan claim re-pointed Claims processor | CLM-432480 → UHC-41101-83 (Willie Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006245 | Orphan claim re-pointed Claims processor | CLM-418240 → UHC-25880-45 (Abigail Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006246 | Orphan claim re-pointed Claims processor | CLM-402470 → UHC-88883-33 (Joyce Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006247 | Orphan claim re-pointed Claims processor | CLM-418225 → UHC-16307-85 (Mariana Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006248 | Orphan claim re-pointed Claims processor | CLM-410815 → UHC-44213-31 (Mason Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006249 | Orphan claim re-pointed Claims processor | CLM-409451 → UHC-21212-52 (Rachel Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006250 | Orphan claim re-pointed Claims processor | CLM-415542 → UHC-50444-71 (Kenneth Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006251 | Orphan claim re-pointed Claims processor | CLM-422395 → UHC-40350-50 (Joshua Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006252 | Orphan claim re-pointed Claims processor | CLM-430891 → UHC-11124-73 (Christopher Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006253 | Orphan claim re-pointed Claims processor | CLM-424931 → UHC-36040-90 (Wayne Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006254 | Orphan claim re-pointed Claims processor | CLM-404746 → UHC-98269-55 (Kathleen Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006255 | Orphan claim re-pointed Claims processor | CLM-411991 → UHC-17863-08 (Valentina Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006256 | Orphan claim re-pointed Claims processor | CLM-415354 → UHC-75623-35 (Kenneth Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006257 | Orphan claim re-pointed Claims processor | CLM-418699 → UHC-36004-77 (George Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006258 | Orphan claim re-pointed Claims processor | CLM-418460 → UHC-74181-40 (Jack Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006259 | Orphan claim re-pointed Claims processor | CLM-423607 → UHC-51692-81 (Bruce Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006260 | Orphan claim re-pointed Claims processor | CLM-411116 → UHC-10107-56 (Becky Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006261 | Orphan claim re-pointed Claims processor | CLM-405027 → UHC-11856-62 (George Jensen) |
| 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.