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-006512 | Orphan claim re-pointed Claims processor | CLM-406256 → UHC-88685-49 (Linda Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006513 | Orphan claim re-pointed Claims processor | CLM-431442 → UHC-81453-36 (Emily Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006514 | Orphan claim re-pointed Claims processor | CLM-431582 → UHC-45541-40 (Aaron Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006515 | Orphan claim re-pointed Claims processor | CLM-428163 → UHC-98443-74 (Brandon Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006516 | Orphan claim re-pointed Claims processor | CLM-418003 → UHC-57515-46 (Betty Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006517 | Orphan claim re-pointed Claims processor | CLM-407337 → UHC-68589-33 (Elijah Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006518 | Orphan claim re-pointed Claims processor | CLM-407205 → UHC-44926-42 (Sara Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006519 | Orphan claim re-pointed Claims processor | CLM-411059 → UHC-24608-69 (Mateo Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006520 | Orphan claim re-pointed Claims processor | CLM-420392 → UHC-42580-56 (Brittany Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006521 | Orphan claim re-pointed Claims processor | CLM-431216 → UHC-22023-59 (Sean Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006522 | Orphan claim re-pointed Claims processor | CLM-409071 → UHC-25511-74 (Santiago McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006523 | Orphan claim re-pointed Claims processor | CLM-418571 → UHC-58484-22 (Susan Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006524 | Orphan claim re-pointed Claims processor | CLM-404640 → UHC-42879-41 (Douglas Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006525 | Orphan claim re-pointed Claims processor | CLM-426853 → UHC-51529-10 (Jimmy Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006526 | Orphan claim re-pointed Claims processor | CLM-420245 → UHC-52979-83 (Ethan Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006527 | Orphan claim re-pointed Claims processor | CLM-425365 → UHC-23902-55 (Jnaet Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006528 | Orphan claim re-pointed Claims processor | CLM-410438 → UHC-82278-33 (Martha Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006529 | Orphan claim re-pointed Claims processor | CLM-408086 → UHC-63754-29 (Ryan Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006530 | Orphan claim re-pointed Claims processor | CLM-426507 → UHC-96381-04 (Jordan Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006531 | Orphan claim re-pointed Claims processor | CLM-414811 → UHC-30785-89 (Deborah Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006532 | Orphan claim re-pointed Claims processor | CLM-429008 → UHC-36432-76 (Peter Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006533 | Orphan claim re-pointed Claims processor | CLM-426594 → UHC-52659-75 (Keith Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006534 | Orphan claim re-pointed Claims processor | CLM-410311 → UHC-27089-19 (Deborah Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006535 | Orphan claim re-pointed Claims processor | CLM-403406 → UHC-20825-98 (Mariana Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006536 | Orphan claim re-pointed Claims processor | CLM-431210 → UHC-35273-61 (Arjun Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006537 | Orphan claim re-pointed Claims processor | CLM-432569 → UHC-83352-41 (Stephanie Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006538 | Orphan claim re-pointed Claims processor | CLM-400409 → UHC-34435-37 (Mary Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006539 | Orphan claim re-pointed Claims processor | CLM-417047 → UHC-64875-75 (Lori Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006540 | Orphan claim re-pointed Claims processor | CLM-424207 → UHC-53662-77 (Linda Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006541 | Orphan claim re-pointed Claims processor | CLM-405274 → UHC-53272-81 (Willie Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006542 | Orphan claim re-pointed Claims processor | CLM-423786 → UHC-47709-74 (Grace Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006543 | Orphan claim re-pointed Claims processor | CLM-419334 → UHC-64701-90 (Gregory James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006544 | Orphan claim re-pointed Claims processor | CLM-411629 → UHC-25626-75 (Helen West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006545 | Orphan claim re-pointed Claims processor | CLM-407597 → UHC-74481-70 (Beverly Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006546 | Orphan claim re-pointed Claims processor | CLM-432261 → UHC-71373-79 (Julie Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006547 | Orphan claim re-pointed Claims processor | CLM-429056 → UHC-54406-84 (Billy Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006548 | Orphan claim re-pointed Claims processor | CLM-430873 → UHC-04410-99 (Michelle Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006549 | Orphan claim re-pointed Claims processor | CLM-400319 → UHC-62796-06 (Anthony Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006550 | Orphan claim re-pointed Claims processor | CLM-400609 → UHC-30577-22 (Kenneth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006551 | Orphan claim re-pointed Claims processor | CLM-416798 → UHC-60254-75 (Frank Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006552 | Orphan claim re-pointed Claims processor | CLM-402225 → UHC-70976-57 (Kimberly Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006553 | Orphan claim re-pointed Claims processor | CLM-405529 → UHC-66614-26 (Denise Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006554 | Orphan claim re-pointed Claims processor | CLM-416747 → UHC-44585-61 (Larry Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006555 | Orphan claim re-pointed Claims processor | CLM-422351 → UHC-49069-01 (Matthew Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006556 | Orphan claim re-pointed Claims processor | CLM-419302 → UHC-22662-71 (Adam Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006557 | Orphan claim re-pointed Claims processor | CLM-403532 → UHC-45932-54 (Mateo Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006558 | Orphan claim re-pointed Claims processor | CLM-430470 → UHC-25311-18 (Kathryn Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006559 | Orphan claim re-pointed Claims processor | CLM-400618 → UHC-81856-96 (Gary Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006560 | Orphan claim re-pointed Claims processor | CLM-419358 → UHC-52218-29 (Barbara Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006561 | Orphan claim re-pointed Claims processor | CLM-425981 → UHC-64643-77 (Gerald McDonald) |
| 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.