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-006662 | Orphan claim re-pointed Claims processor | CLM-427689 → UHC-78757-55 (Timothy Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006663 | Orphan claim re-pointed Claims processor | CLM-417163 → UHC-24502-41 (Luis Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006664 | Orphan claim re-pointed Claims processor | CLM-413421 → UHC-64405-22 (Noah Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006665 | Orphan claim re-pointed Claims processor | CLM-426367 → UHC-15488-51 (Mei Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006666 | Orphan claim re-pointed Claims processor | CLM-400766 → UHC-07622-81 (Samuel Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006667 | Orphan claim re-pointed Claims processor | CLM-411834 → UHC-67677-60 (Sarah Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006668 | Orphan claim re-pointed Claims processor | CLM-415651 → UHC-42406-33 (Joshua Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006669 | Orphan claim re-pointed Claims processor | CLM-409815 → UHC-71563-08 (Matthew Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006670 | Orphan claim re-pointed Claims processor | CLM-405104 → UHC-46284-07 (Amanda Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006671 | Orphan claim re-pointed Claims processor | CLM-409133 → UHC-78843-89 (Don Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006672 | Orphan claim re-pointed Claims processor | CLM-419382 → UHC-18151-19 (Catherine Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006673 | Orphan claim re-pointed Claims processor | CLM-400227 → UHC-87537-12 (Evelyn Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006674 | Orphan claim re-pointed Claims processor | CLM-403817 → UHC-20741-25 (Jesse Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006675 | Orphan claim re-pointed Claims processor | CLM-422122 → UHC-96592-26 (Mark Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006676 | Orphan claim re-pointed Claims processor | CLM-431617 → UHC-72010-71 (Daniel Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006677 | Orphan claim re-pointed Claims processor | CLM-427035 → UHC-14530-18 (Luis Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006678 | Orphan claim re-pointed Claims processor | CLM-425270 → UHC-11065-29 (Bruce Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006679 | Orphan claim re-pointed Claims processor | CLM-430294 → UHC-73490-52 (Helen Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006680 | Orphan claim re-pointed Claims processor | CLM-415038 → UHC-54030-96 (Carlos Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006681 | Orphan claim re-pointed Claims processor | CLM-418628 → UHC-05969-13 (John Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006682 | Orphan claim re-pointed Claims processor | CLM-400786 → UHC-57559-48 (James Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006683 | Orphan claim re-pointed Claims processor | CLM-405556 → UHC-59137-20 (Brian Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006684 | Orphan claim re-pointed Claims processor | CLM-418105 → UHC-57452-96 (Joshua Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006685 | Orphan claim re-pointed Claims processor | CLM-408681 → UHC-06628-52 (Christian Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006686 | Orphan claim re-pointed Claims processor | CLM-402120 → UHC-74464-51 (Ray Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006687 | Orphan claim re-pointed Claims processor | CLM-424289 → UHC-86475-61 (Mei King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006688 | Orphan claim re-pointed Claims processor | CLM-403136 → UHC-74882-41 (Hannah Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006689 | Orphan claim re-pointed Claims processor | CLM-414295 → UHC-05912-11 (Camila Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006690 | Orphan claim re-pointed Claims processor | CLM-425108 → UHC-26275-01 (Hiroshi Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006691 | Orphan claim re-pointed Claims processor | CLM-411140 → UHC-44848-39 (Roy Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006692 | Orphan claim re-pointed Claims processor | CLM-423391 → UHC-44535-99 (Hiroshi Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006693 | Orphan claim re-pointed Claims processor | CLM-421860 → UHC-15847-88 (Judith Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006694 | Orphan claim re-pointed Claims processor | CLM-418720 → UHC-11833-22 (Ralph Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006695 | Orphan claim re-pointed Claims processor | CLM-419356 → UHC-07141-01 (Wei Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006696 | Orphan claim re-pointed Claims processor | CLM-427490 → UHC-29672-58 (Kyle Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006697 | Orphan claim re-pointed Claims processor | CLM-405562 → UHC-20430-16 (Grace Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006698 | Orphan claim re-pointed Claims processor | CLM-420574 → UHC-90230-78 (Theresa Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006699 | Orphan claim re-pointed Claims processor | CLM-430467 → UHC-12576-48 (Lisa Jorrdan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006700 | Orphan claim re-pointed Claims processor | CLM-408612 → UHC-65445-38 (Matthew Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006701 | Orphan claim re-pointed Claims processor | CLM-408584 → UHC-51657-47 (Mei Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006702 | Orphan claim re-pointed Claims processor | CLM-414849 → UHC-75410-20 (Pamela Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006703 | Orphan claim re-pointed Claims processor | CLM-432372 → UHC-36196-33 (Ana Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006704 | Orphan claim re-pointed Claims processor | CLM-426046 → UHC-49200-73 (Roy Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006705 | Orphan claim re-pointed Claims processor | CLM-406116 → UHC-97443-27 (Jacqueline Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006706 | Orphan claim re-pointed Claims processor | CLM-429374 → UHC-79290-49 (Russell Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006707 | Orphan claim re-pointed Claims processor | CLM-404225 → UHC-91449-50 (Christnie Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006708 | Orphan claim re-pointed Claims processor | CLM-405032 → UHC-92637-64 (Christopher Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006709 | Orphan claim re-pointed Claims processor | CLM-410421 → UHC-57823-65 (Adrew Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006710 | Orphan claim re-pointed Claims processor | CLM-415649 → UHC-79616-93 (Arthur Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006711 | Orphan claim re-pointed Claims processor | CLM-431272 → UHC-53720-04 (Margaret Watson) |
| 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.