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-006362 | Orphan claim re-pointed Claims processor | CLM-400365 → UHC-77060-06 (Ana Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006363 | Orphan claim re-pointed Claims processor | CLM-417425 → UHC-46623-02 (Donna Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006364 | Orphan claim re-pointed Claims processor | CLM-425752 → UHC-12395-95 (Nicole Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006365 | Orphan claim re-pointed Claims processor | CLM-427796 → UHC-05394-63 (Christina Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006366 | Orphan claim re-pointed Claims processor | CLM-426138 → UHC-89486-51 (Shaaron Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006367 | Orphan claim re-pointed Claims processor | CLM-420086 → UHC-40806-34 (Betty Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006368 | Orphan claim re-pointed Claims processor | CLM-401790 → UHC-38852-43 (Walter Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006369 | Orphan claim re-pointed Claims processor | CLM-414127 → UHC-68065-70 (George Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006370 | Orphan claim re-pointed Claims processor | CLM-416682 → UHC-48642-30 (Kayla Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006371 | Orphan claim re-pointed Claims processor | CLM-431934 → UHC-33190-68 (Austin Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006372 | Orphan claim re-pointed Claims processor | CLM-420045 → UHC-49350-55 (Isabella Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006373 | Orphan claim re-pointed Claims processor | CLM-431178 → UHC-58544-19 (Carolyn George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006374 | Orphan claim re-pointed Claims processor | CLM-426121 → UHC-22906-03 (Janet Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006375 | Orphan claim re-pointed Claims processor | CLM-428182 → UHC-38703-93 (Judith Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006376 | Orphan claim re-pointed Claims processor | CLM-419499 → UHC-07066-33 (Mason Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006377 | Orphan claim re-pointed Claims processor | CLM-423282 → UHC-89788-22 (Heather Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006378 | Orphan claim re-pointed Claims processor | CLM-411439 → UHC-06212-91 (Brenda Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006379 | Orphan claim re-pointed Claims processor | CLM-427418 → UHC-09454-42 (Karen Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006380 | Orphan claim re-pointed Claims processor | CLM-416684 → UHC-74628-55 (Danielle Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006381 | Orphan claim re-pointed Claims processor | CLM-431171 → UHC-95327-83 (Paul Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006382 | Orphan claim re-pointed Claims processor | CLM-403964 → UHC-07860-94 (Joyce Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006383 | Orphan claim re-pointed Claims processor | CLM-417942 → UHC-70642-50 (Andrew Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006384 | Orphan claim re-pointed Claims processor | CLM-401584 → UHC-95759-83 (Wayne Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006385 | Orphan claim re-pointed Claims processor | CLM-431706 → UHC-56875-41 (Christine Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006386 | Orphan claim re-pointed Claims processor | CLM-408869 → UHC-73064-35 (Walter Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006387 | Orphan claim re-pointed Claims processor | CLM-423462 → UHC-55793-41 (Ashley Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006388 | Orphan claim re-pointed Claims processor | CLM-415291 → UHC-21639-91 (Kathryn Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006389 | Orphan claim re-pointed Claims processor | CLM-411129 → UHC-13273-39 (Nicole Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006390 | Orphan claim re-pointed Claims processor | CLM-409724 → UHC-81866-57 (Alan Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006391 | Orphan claim re-pointed Claims processor | CLM-427073 → UHC-77787-12 (Deborah Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006392 | Orphan claim re-pointed Claims processor | CLM-402357 → UHC-74681-79 (Philip Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006393 | Orphan claim re-pointed Claims processor | CLM-406132 → UHC-48973-10 (Kyle Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006394 | Orphan claim re-pointed Claims processor | CLM-421604 → UHC-28587-16 (Andrew Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006395 | Orphan claim re-pointed Claims processor | CLM-404005 → UHC-29740-76 (Ryan Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006396 | Orphan claim re-pointed Claims processor | CLM-405639 → UHC-07124-52 (Ruth Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006397 | Orphan claim re-pointed Claims processor | CLM-404061 → UHC-71322-95 (Lauren Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006398 | Orphan claim re-pointed Claims processor | CLM-414022 → UHC-08635-40 (Joe Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006399 | Orphan claim re-pointed Claims processor | CLM-400757 → UHC-59786-48 (Jennifer Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006400 | Orphan claim re-pointed Claims processor | CLM-412473 → UHC-65412-57 (Jake Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006401 | Orphan claim re-pointed Claims processor | CLM-407388 → UHC-20290-28 (Grace Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006402 | Orphan claim re-pointed Claims processor | CLM-400959 → UHC-15651-83 (Patricia Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006403 | Orphan claim re-pointed Claims processor | CLM-419219 → UHC-20139-14 (Alice Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006404 | Orphan claim re-pointed Claims processor | CLM-412334 → UHC-82124-06 (Keith McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006405 | Orphan claim re-pointed Claims processor | CLM-410006 → UHC-60458-38 (Gerald Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006406 | Orphan claim re-pointed Claims processor | CLM-420382 → UHC-83055-57 (Emily Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006407 | Orphan claim re-pointed Claims processor | CLM-403621 → UHC-06126-03 (Kenneth Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006408 | Orphan claim re-pointed Claims processor | CLM-423525 → UHC-46677-80 (Patel Pamela) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006409 | Orphan claim re-pointed Claims processor | CLM-429358 → UHC-48884-02 (Natalie Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006410 | Orphan claim re-pointed Claims processor | CLM-408981 → UHC-77997-41 (Eugene Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006411 | Orphan claim re-pointed Claims processor | CLM-403287 → UHC-86192-80 (Frances Alvarez) |
| 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.