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-006462 | Orphan claim re-pointed Claims processor | CLM-420753 → UHC-54629-26 (Mariana Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006463 | Orphan claim re-pointed Claims processor | CLM-410528 → UHC-32682-08 (Diego Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006464 | Orphan claim re-pointed Claims processor | CLM-427031 → UHC-03053-87 (Rebecca Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006465 | Orphan claim re-pointed Claims processor | CLM-410770 → UHC-13519-75 (Abigail Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006466 | Orphan claim re-pointed Claims processor | CLM-416048 → UHC-73952-53 (Virginia Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006467 | Orphan claim re-pointed Claims processor | CLM-432712 → UHC-28510-22 (Janice Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006468 | Orphan claim re-pointed Claims processor | CLM-401304 → UHC-67277-92 (Santiago Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006469 | Orphan claim re-pointed Claims processor | CLM-424634 → UHC-40221-33 (Dylan Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006470 | Orphan claim re-pointed Claims processor | CLM-413167 → UHC-58593-18 (Logan Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006471 | Orphan claim re-pointed Claims processor | CLM-412399 → UHC-73546-71 (Scott Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006472 | Orphan claim re-pointed Claims processor | CLM-429863 → UHC-03108-13 (Madison Cok) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006473 | Orphan claim re-pointed Claims processor | CLM-419588 → UHC-89576-14 (Karen Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006474 | Orphan claim re-pointed Claims processor | CLM-403313 → UHC-34954-61 (Beverly Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006475 | Orphan claim re-pointed Claims processor | CLM-426454 → UHC-13952-43 (Margaret Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006476 | Orphan claim re-pointed Claims processor | CLM-416692 → UHC-33115-57 (Brian Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006477 | Orphan claim re-pointed Claims processor | CLM-409448 → UHC-90845-02 (Sara Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006478 | Orphan claim re-pointed Claims processor | CLM-425233 → UHC-95741-07 (Paul Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006479 | Orphan claim re-pointed Claims processor | CLM-419624 → UHC-61833-29 (Logan Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006480 | Orphan claim re-pointed Claims processor | CLM-432206 → UHC-15995-20 (Russell Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006481 | Orphan claim re-pointed Claims processor | CLM-410957 → UHC-21646-86 (Fatima Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006482 | Orphan claim re-pointed Claims processor | CLM-418711 → UHC-30537-94 (Janice West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006483 | Orphan claim re-pointed Claims processor | CLM-430358 → UHC-77648-76 (Jean Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006484 | Orphan claim re-pointed Claims processor | CLM-401650 → UHC-99173-76 (Doris Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006485 | Orphan claim re-pointed Claims processor | CLM-427285 → UHC-03949-82 (Nathan Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006486 | Orphan claim re-pointed Claims processor | CLM-428956 → UHC-60761-77 (Jessica Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006487 | Orphan claim re-pointed Claims processor | CLM-422637 → UHC-97584-08 (Juan Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006488 | Orphan claim re-pointed Claims processor | CLM-408462 → UHC-01984-24 (Brenda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006489 | Orphan claim re-pointed Claims processor | CLM-409124 → UHC-27870-32 (Jennifer Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006490 | Orphan claim re-pointed Claims processor | CLM-429771 → UHC-43808-81 (Jean Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006491 | Orphan claim re-pointed Claims processor | CLM-431501 → UHC-06739-36 (Evelyn Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006492 | Orphan claim re-pointed Claims processor | CLM-419364 → UHC-07269-10 (Sofia Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006493 | Orphan claim re-pointed Claims processor | CLM-426227 → UHC-72872-02 (Samantha Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006494 | Orphan claim re-pointed Claims processor | CLM-416173 → UHC-47916-16 (Ethan Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006495 | Orphan claim re-pointed Claims processor | CLM-403455 → UHC-57070-14 (Roy Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006496 | Orphan claim re-pointed Claims processor | CLM-431464 → UHC-16807-44 (Larry Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006497 | Orphan claim re-pointed Claims processor | CLM-408735 → UHC-07444-96 (Bryan Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006498 | Orphan claim re-pointed Claims processor | CLM-418080 → UHC-79666-91 (Edward Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006499 | Orphan claim re-pointed Claims processor | CLM-401182 → UHC-89423-86 (Diego Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006500 | Orphan claim re-pointed Claims processor | CLM-425515 → UHC-18011-83 (Walter Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006501 | Orphan claim re-pointed Claims processor | CLM-418666 → UHC-82723-91 (Christian James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006502 | Orphan claim re-pointed Claims processor | CLM-425558 → UHC-87911-25 (Bobby Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006503 | Orphan claim re-pointed Claims processor | CLM-409115 → UHC-68068-92 (Sean Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006504 | Orphan claim re-pointed Claims processor | CLM-400169 → UHC-15231-47 (Paul Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006505 | Orphan claim re-pointed Claims processor | CLM-429899 → UHC-27590-46 (Jacob Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006506 | Orphan claim re-pointed Claims processor | CLM-413932 → UHC-86947-07 (Timothy Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006507 | Orphan claim re-pointed Claims processor | CLM-431271 → UHC-53720-04 (Margaret Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006508 | Orphan claim re-pointed Claims processor | CLM-409310 → UHC-30817-37 (Cheryl Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006509 | Orphan claim re-pointed Claims processor | CLM-427483 → UHC-95042-59 (Wayne Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006510 | Orphan claim re-pointed Claims processor | CLM-425747 → UHC-12376-13 (Hannah Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006511 | Orphan claim re-pointed Claims processor | CLM-417148 → UHC-77064-16 (Kayla Gibson) |
| 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.