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-006562 | Orphan claim re-pointed Claims processor | CLM-431142 → UHC-45290-96 (Roger Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006563 | Orphan claim re-pointed Claims processor | CLM-410824 → UHC-96374-15 (Christian Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006564 | Orphan claim re-pointed Claims processor | CLM-431756 → UHC-65635-70 (Ann Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006565 | Orphan claim re-pointed Claims processor | CLM-400056 → UHC-43942-38 (Samantha Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006566 | Orphan claim re-pointed Claims processor | CLM-407382 → UHC-21518-10 (Santiago Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006567 | Orphan claim re-pointed Claims processor | CLM-427717 → UHC-59486-30 (David Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006568 | Orphan claim re-pointed Claims processor | CLM-418280 → UHC-40140-87 (Beverly Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006569 | Orphan claim re-pointed Claims processor | CLM-415374 → UHC-70639-44 (Jennifer Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006570 | Orphan claim re-pointed Claims processor | CLM-431721 → UHC-24034-56 (Joan Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006571 | Orphan claim re-pointed Claims processor | CLM-411985 → UHC-74637-63 (Aishha Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006572 | Orphan claim re-pointed Claims processor | CLM-409513 → UHC-74702-59 (Abigail Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006573 | Orphan claim re-pointed Claims processor | CLM-421735 → UHC-80133-34 (Luis Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006574 | Orphan claim re-pointed Claims processor | CLM-414451 → UHC-13952-38 (Yuki Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006575 | Orphan claim re-pointed Claims processor | CLM-403757 → UHC-01798-59 (Justin Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006576 | Orphan claim re-pointed Claims processor | CLM-431962 → UHC-03242-36 (Ralph Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006577 | Orphan claim re-pointed Claims processor | CLM-424624 → UHC-02015-72 (Christian Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006578 | Orphan claim re-pointed Claims processor | CLM-420081 → UHC-53253-11 (Kimberly Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006579 | Orphan claim re-pointed Claims processor | CLM-424351 → UHC-87114-24 (Dennis Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006580 | Orphan claim re-pointed Claims processor | CLM-406515 → UHC-58654-72 (Virginia Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006581 | Orphan claim re-pointed Claims processor | CLM-402906 → UHC-06664-40 (Janice Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006582 | Orphan claim re-pointed Claims processor | CLM-425118 → UHC-39317-97 (Alice Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006583 | Orphan claim re-pointed Claims processor | CLM-425183 → UHC-65473-87 (Henry Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006584 | Orphan claim re-pointed Claims processor | CLM-429809 → UHC-24187-59 (Denise Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006585 | Orphan claim re-pointed Claims processor | CLM-410070 → UHC-26564-74 (Natalie McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006586 | Orphan claim re-pointed Claims processor | CLM-408704 → UHC-40234-04 (Amanda Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006587 | Orphan claim re-pointed Claims processor | CLM-428313 → UHC-41409-07 (Andrew McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006588 | Orphan claim re-pointed Claims processor | CLM-416942 → UHC-53088-33 (Dorothy Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006589 | Orphan claim re-pointed Claims processor | CLM-428549 → UHC-70852-06 (Shirley Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006590 | Orphan claim re-pointed Claims processor | CLM-430453 → UHC-05137-74 (Ralph Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006591 | Orphan claim re-pointed Claims processor | CLM-418446 → UHC-23443-73 (Maria Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006592 | Orphan claim re-pointed Claims processor | CLM-409294 → UHC-40363-22 (Stephanie Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006593 | Orphan claim re-pointed Claims processor | CLM-401854 → UHC-58248-42 (Edward Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006594 | Orphan claim re-pointed Claims processor | CLM-429782 → UHC-26994-62 (David Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006595 | Orphan claim re-pointed Claims processor | CLM-414429 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006596 | Orphan claim re-pointed Claims processor | CLM-415643 → UHC-23041-70 (Austin Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006597 | Orphan claim re-pointed Claims processor | CLM-412636 → UHC-56622-34 (Mateo Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006598 | Orphan claim re-pointed Claims processor | CLM-409110 → UHC-23250-48 (Donald Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006599 | Orphan claim re-pointed Claims processor | CLM-430907 → UHC-48436-70 (Eugene Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006600 | Orphan claim re-pointed Claims processor | CLM-419254 → UHC-86844-01 (Christopher Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006601 | Orphan claim re-pointed Claims processor | CLM-426289 → UHC-96050-09 (Laura Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006602 | Orphan claim re-pointed Claims processor | CLM-407362 → UHC-50068-89 (Gary Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006603 | Orphan claim re-pointed Claims processor | CLM-410611 → UHC-19999-31 (Gregory Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006604 | Orphan claim re-pointed Claims processor | CLM-424710 → UHC-07807-62 (Dylan Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006605 | Orphan claim re-pointed Claims processor | CLM-409863 → UHC-68463-16 (Terrry Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006606 | Orphan claim re-pointed Claims processor | CLM-424913 → UHC-19333-94 (Isabella Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006607 | Orphan claim re-pointed Claims processor | CLM-403229 → UHC-28097-08 (Megan Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006608 | Orphan claim re-pointed Claims processor | CLM-418087 → UHC-42099-41 (Margaret Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006609 | Orphan claim re-pointed Claims processor | CLM-420299 → UHC-59686-02 (Diana Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006610 | Orphan claim re-pointed Claims processor | CLM-406598 → UHC-13185-09 (Emma Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006611 | Orphan claim re-pointed Claims processor | CLM-431173 → UHC-33328-14 (Virginia Fernandez) |
| 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.