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-006262 | Orphan claim re-pointed Claims processor | CLM-412317 → UHC-80658-32 (John Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006263 | Orphan claim re-pointed Claims processor | CLM-413253 → UHC-03469-36 (Jason Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006264 | Orphan claim re-pointed Claims processor | CLM-413190 → UHC-98170-43 (Frank Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006265 | Orphan claim re-pointed Claims processor | CLM-403673 → UHC-13848-92 (Carl Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006266 | Orphan claim re-pointed Claims processor | CLM-401196 → UHC-54131-68 (Noah West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006267 | Orphan claim re-pointed Claims processor | CLM-426646 → UHC-22256-78 (Teresa Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006268 | Orphan claim re-pointed Claims processor | CLM-425505 → UHC-68889-27 (Lauren Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006269 | Orphan claim re-pointed Claims processor | CLM-418998 → UHC-17308-74 (Cynthia Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006270 | Orphan claim re-pointed Claims processor | CLM-406137 → UHC-53245-53 (Diana Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006271 | Orphan claim re-pointed Claims processor | CLM-407893 → UHC-56808-89 (Alexis Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006272 | Orphan claim re-pointed Claims processor | CLM-431903 → UHC-97072-12 (Marilyn Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006273 | Orphan claim re-pointed Claims processor | CLM-418044 → UHC-30065-10 (Susan Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006274 | Orphan claim re-pointed Claims processor | CLM-427812 → UHC-48990-31 (Sophia Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006275 | Orphan claim re-pointed Claims processor | CLM-420328 → UHC-47052-61 (Kyle Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006276 | Orphan claim re-pointed Claims processor | CLM-432087 → UHC-15097-94 (Bruce Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006277 | Orphan claim re-pointed Claims processor | CLM-417537 → UHC-80596-07 (Alexis Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006278 | Orphan claim re-pointed Claims processor | CLM-425015 → UHC-09937-27 (Alan Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006279 | Orphan claim re-pointed Claims processor | CLM-426449 → UHC-50583-39 (Evelyn Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006280 | Orphan claim re-pointed Claims processor | CLM-419216 → UHC-00875-09 (Heather Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006281 | Orphan claim re-pointed Claims processor | CLM-417757 → UHC-74409-30 (Carlos Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006282 | Orphan claim re-pointed Claims processor | CLM-419661 → UHC-71122-27 (Robert Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006283 | Orphan claim re-pointed Claims processor | CLM-416156 → UHC-03974-15 (Priya Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006284 | Orphan claim re-pointed Claims processor | CLM-401533 → UHC-84044-07 (Donna Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006285 | Orphan claim re-pointed Claims processor | CLM-409612 → UHC-82287-41 (Virginia Marrtin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006286 | Orphan claim re-pointed Claims processor | CLM-406726 → UHC-76376-81 (Sarah James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006287 | Orphan claim re-pointed Claims processor | CLM-421588 → UHC-19735-38 (Patricia Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006288 | Orphan claim re-pointed Claims processor | CLM-404593 → UHC-26271-13 (Eugene Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006289 | Orphan claim re-pointed Claims processor | CLM-407792 → UHC-98913-03 (Carol Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006290 | Orphan claim re-pointed Claims processor | CLM-411531 → UHC-28703-46 (Beverly Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006291 | Orphan claim re-pointed Claims processor | CLM-403090 → UHC-81250-72 (Patricia Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006292 | Orphan claim re-pointed Claims processor | CLM-410693 → UHC-84665-74 (David Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006293 | Orphan claim re-pointed Claims processor | CLM-428757 → UHC-13138-62 (Gabriel Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006294 | Orphan claim re-pointed Claims processor | CLM-406469 → UHC-48765-83 (Shirley Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006295 | Orphan claim re-pointed Claims processor | CLM-409413 → UHC-95872-02 (Lori Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006296 | Orphan claim re-pointed Claims processor | CLM-407425 → UHC-39892-95 (Kyle Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006297 | Orphan claim re-pointed Claims processor | CLM-416914 → UHC-31740-79 (Liz Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006298 | Orphan claim re-pointed Claims processor | CLM-422280 → UHC-59633-24 (Maria Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006299 | Orphan claim re-pointed Claims processor | CLM-404509 → UHC-80230-70 (Daniel Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006300 | Orphan claim re-pointed Claims processor | CLM-424167 → UHC-44839-36 (Mark Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006301 | Orphan claim re-pointed Claims processor | CLM-410327 → UHC-10708-73 (Brian Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006302 | Orphan claim re-pointed Claims processor | CLM-430594 → UHC-58072-95 (Susan Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006303 | Orphan claim re-pointed Claims processor | CLM-408085 → UHC-63754-29 (Ryan Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006304 | Orphan claim re-pointed Claims processor | CLM-420508 → UHC-34589-55 (Judith Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006305 | Orphan claim re-pointed Claims processor | CLM-414145 → UHC-35506-90 (Kelly Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006306 | Orphan claim re-pointed Claims processor | CLM-422490 → UHC-08655-80 (Kevin Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006307 | Orphan claim re-pointed Claims processor | CLM-400081 → UHC-44743-32 (Jonathan Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006308 | Orphan claim re-pointed Claims processor | CLM-405454 → UHC-21109-44 (Rachel Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006309 | Orphan claim re-pointed Claims processor | CLM-401786 → UHC-40299-97 (Madison Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006310 | Orphan claim re-pointed Claims processor | CLM-414248 → UHC-93744-90 (Logan Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006311 | Orphan claim re-pointed Claims processor | CLM-402479 → UHC-24096-20 (Lawrence Hansen) |
| 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.