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-006862 | Orphan claim re-pointed Claims processor | CLM-403394 → UHC-81347-87 (Jason Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006863 | Orphan claim re-pointed Claims processor | CLM-400640 → UHC-33970-88 (Billy Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006864 | Orphan claim re-pointed Claims processor | CLM-422207 → UHC-02360-93 (Sara Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006865 | Orphan claim re-pointed Claims processor | CLM-407928 → UHC-87372-54 (Jeremy Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006866 | Orphan claim re-pointed Claims processor | CLM-426332 → UHC-70642-29 (Nancy Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006867 | Orphan claim re-pointed Claims processor | CLM-404211 → UHC-66823-60 (Jeremy Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006868 | Orphan claim re-pointed Claims processor | CLM-409608 → UHC-52959-32 (Paul Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006869 | Orphan claim re-pointed Claims processor | CLM-409565 → UHC-76252-18 (Linda Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006870 | Orphan claim re-pointed Claims processor | CLM-416390 → UHC-94650-89 (Eric Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006871 | Orphan claim re-pointed Claims processor | CLM-415484 → UHC-67722-09 (Gabriel Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006872 | Orphan claim re-pointed Claims processor | CLM-405409 → UHC-63626-44 (Diego Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006873 | Orphan claim re-pointed Claims processor | CLM-429739 → UHC-66691-05 (Austin Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006874 | Orphan claim re-pointed Claims processor | CLM-412795 → UHC-33252-10 (Juan Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006875 | Orphan claim re-pointed Claims processor | CLM-418423 → UHC-24398-42 (Camila Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006876 | Orphan claim re-pointed Claims processor | CLM-405987 → UHC-04821-42 (Deborah Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006877 | Orphan claim re-pointed Claims processor | CLM-402540 → UHC-33344-70 (James Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006878 | Orphan claim re-pointed Claims processor | CLM-422269 → UHC-90693-56 (Roger Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006879 | Orphan claim re-pointed Claims processor | CLM-427824 → UHC-64152-85 (Donna Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006880 | Orphan claim re-pointed Claims processor | CLM-428921 → UHC-70467-12 (Andrea Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006881 | Orphan claim re-pointed Claims processor | CLM-414117 → UHC-48894-38 (Dennis Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006882 | Orphan claim re-pointed Claims processor | CLM-430411 → UHC-37517-47 (Bradley Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006883 | Orphan claim re-pointed Claims processor | CLM-421405 → UHC-02720-67 (Santiago Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006884 | Orphan claim re-pointed Claims processor | CLM-416919 → UHC-12402-61 (Thomas Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006885 | Orphan claim re-pointed Claims processor | CLM-429877 → UHC-41015-83 (Luis Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006886 | Orphan claim re-pointed Claims processor | CLM-415644 → UHC-23041-70 (Austin Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006887 | Orphan claim re-pointed Claims processor | CLM-403738 → UHC-15167-50 (Gerald Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006888 | Orphan claim re-pointed Claims processor | CLM-431072 → UHC-00720-73 (Brenda Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006889 | Orphan claim re-pointed Claims processor | CLM-413354 → UHC-95825-79 (Bruce Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006890 | Orphan claim re-pointed Claims processor | CLM-424833 → UHC-65868-91 (Joe Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006891 | Orphan claim re-pointed Claims processor | CLM-406936 → UHC-21773-81 (Hannah Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006892 | Orphan claim re-pointed Claims processor | CLM-414914 → UHC-85538-22 (Karen Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006893 | Orphan claim re-pointed Claims processor | CLM-412366 → UHC-00101-50 (Madison Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006894 | Orphan claim re-pointed Claims processor | CLM-414387 → UHC-28618-98 (Carl Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006895 | Orphan claim re-pointed Claims processor | CLM-401061 → UHC-71981-48 (Gerald Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006896 | Orphan claim re-pointed Claims processor | CLM-408073 → UHC-66449-14 (James Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006897 | Orphan claim re-pointed Claims processor | CLM-422990 → UHC-16753-86 (Joe Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006898 | Orphan claim re-pointed Claims processor | CLM-421598 → UHC-89226-72 (Jacob Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006899 | Orphan claim re-pointed Claims processor | CLM-428371 → UHC-46632-04 (Beverly Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006900 | Orphan claim re-pointed Claims processor | CLM-427154 → UHC-16769-64 (Lauren Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006901 | Orphan claim re-pointed Claims processor | CLM-411147 → UHC-28541-33 (Noah Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006902 | Orphan claim re-pointed Claims processor | CLM-428769 → UHC-21688-31 (Kyle Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006903 | Orphan claim re-pointed Claims processor | CLM-406325 → UHC-84855-86 (Jeremy Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006904 | Orphan claim re-pointed Claims processor | CLM-402224 → UHC-70976-57 (Kimberly Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006905 | Orphan claim re-pointed Claims processor | CLM-419479 → UHC-40288-97 (Albert Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006906 | Orphan claim re-pointed Claims processor | CLM-412656 → UHC-12513-30 (Elizabeth Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006907 | Orphan claim re-pointed Claims processor | CLM-408261 → UHC-34387-88 (Perry Arthur) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006908 | Orphan claim re-pointed Claims processor | CLM-422583 → UHC-46207-33 (John Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006909 | Orphan claim re-pointed Claims processor | CLM-411967 → UHC-35000-43 (Brian Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006910 | Orphan claim re-pointed Claims processor | CLM-422492 → UHC-46520-71 (Christian Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006911 | Orphan claim re-pointed Claims processor | CLM-421354 → UHC-41910-36 (Jacqueline Singh) |
| 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.