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-006912 | Orphan claim re-pointed Claims processor | CLM-429261 → UHC-93074-69 (Nicholas Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006913 | Orphan claim re-pointed Claims processor | CLM-412188 → UHC-95659-89 (Edward Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006914 | Orphan claim re-pointed Claims processor | CLM-408939 → UHC-86282-68 (Susan Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006915 | Orphan claim re-pointed Claims processor | CLM-403346 → UHC-72868-40 (Sofia Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006916 | Orphan claim re-pointed Claims processor | CLM-428871 → UHC-39159-19 (Walter Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006917 | Orphan claim re-pointed Claims processor | CLM-412945 → UHC-66079-97 (Kyle Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006918 | Orphan claim re-pointed Claims processor | CLM-406597 → UHC-02077-12 (Hiroshi Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006919 | Orphan claim re-pointed Claims processor | CLM-408556 → UHC-16873-01 (Samantha Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006920 | Orphan claim re-pointed Claims processor | CLM-403956 → UHC-64051-96 (Eric Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006921 | Orphan claim re-pointed Claims processor | CLM-413856 → UHC-60806-43 (Gloria Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006922 | Orphan claim re-pointed Claims processor | CLM-404843 → UHC-27496-70 (Yuki Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006923 | Orphan claim re-pointed Claims processor | CLM-427178 → UHC-01681-94 (Steven Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006924 | Orphan claim re-pointed Claims processor | CLM-405422 → UHC-15378-08 (Elijah Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006925 | Orphan claim re-pointed Claims processor | CLM-404739 → UHC-23263-97 (Olivia Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006926 | Orphan claim re-pointed Claims processor | CLM-424778 → UHC-85423-07 (Frank Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006927 | Orphan claim re-pointed Claims processor | CLM-418476 → UHC-01651-17 (Ana Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006928 | Orphan claim re-pointed Claims processor | CLM-401163 → UHC-83592-91 (Sara Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006929 | Orphan claim re-pointed Claims processor | CLM-432344 → UHC-21632-60 (Jeremy Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006930 | Orphan claim re-pointed Claims processor | CLM-413748 → UHC-39290-28 (Pamela Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006931 | Orphan claim re-pointed Claims processor | CLM-430063 → UHC-86199-06 (Benjamin Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006932 | Orphan claim re-pointed Claims processor | CLM-432236 → UHC-26182-08 (Aisha Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006933 | Orphan claim re-pointed Claims processor | CLM-422525 → UHC-31180-51 (Jonh Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006934 | Orphan claim re-pointed Claims processor | CLM-419899 → UHC-83000-99 (Amy Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006935 | Orphan claim re-pointed Claims processor | CLM-421732 → UHC-43398-29 (Susan Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006936 | Orphan claim re-pointed Claims processor | CLM-417580 → UHC-16030-05 (Henry Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006937 | Orphan claim re-pointed Claims processor | CLM-412194 → UHC-98578-71 (Ralph Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006938 | Orphan claim re-pointed Claims processor | CLM-420558 → UHC-11551-57 (Ethan Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006939 | Orphan claim re-pointed Claims processor | CLM-420137 → UHC-10024-45 (Alexander Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006940 | Orphan claim re-pointed Claims processor | CLM-427700 → UHC-33223-95 (Katherine West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006941 | Orphan claim re-pointed Claims processor | CLM-417326 → UHC-89739-33 (Dennis Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006942 | Orphan claim re-pointed Claims processor | CLM-417348 → UHC-62307-74 (Lawrence Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006943 | Orphan claim re-pointed Claims processor | CLM-405121 → UHC-60419-18 (Steven Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006944 | Orphan claim re-pointed Claims processor | CLM-412066 → UHC-79382-41 (Ruth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006945 | Orphan claim re-pointed Claims processor | CLM-420796 → UHC-91720-52 (Aaron Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006946 | Orphan claim re-pointed Claims processor | CLM-402045 → UHC-95997-72 (Brian Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006947 | Orphan claim re-pointed Claims processor | CLM-404487 → UHC-64676-94 (Mason Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006948 | Orphan claim re-pointed Claims processor | CLM-411856 → UHC-29394-99 (Jason Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006949 | Orphan claim re-pointed Claims processor | CLM-415424 → UHC-21736-01 (Ahmed Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006950 | Orphan claim re-pointed Claims processor | CLM-432180 → UHC-18459-11 (Doris Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006951 | Orphan claim re-pointed Claims processor | CLM-414924 → UHC-51151-71 (Gabriel Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006952 | Orphan claim re-pointed Claims processor | CLM-402882 → UHC-00099-58 (Gloria Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006953 | Orphan claim re-pointed Claims processor | CLM-431057 → UHC-10098-84 (Ashley Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006954 | Orphan claim re-pointed Claims processor | CLM-432508 → UHC-81285-76 (Kevin Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006955 | Orphan claim re-pointed Claims processor | CLM-419280 → UHC-71262-56 (Austin Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006956 | Orphan claim re-pointed Claims processor | CLM-431830 → UHC-09549-19 (Russell Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006957 | Orphan claim re-pointed Claims processor | CLM-412335 → UHC-29479-71 (Stephen Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006958 | Orphan claim re-pointed Claims processor | CLM-421149 → UHC-31075-42 (Matthew Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006959 | Orphan claim re-pointed Claims processor | CLM-427029 → UHC-89619-29 (Doris Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006960 | Orphan claim re-pointed Claims processor | CLM-419609 → UHC-09077-92 (Isabella Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006961 | Orphan claim re-pointed Claims processor | CLM-404857 → UHC-20418-29 (Arthur Harris) |
| 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.