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-006962 | Orphan claim re-pointed Claims processor | CLM-405521 → UHC-19959-40 (Priya Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006963 | Orphan claim re-pointed Claims processor | CLM-431816 → UHC-08988-90 (Camila Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006964 | Orphan claim re-pointed Claims processor | CLM-409207 → UHC-33869-68 (Jonathan Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006965 | Orphan claim re-pointed Claims processor | CLM-417622 → UHC-02623-23 (Austin Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006966 | Orphan claim re-pointed Claims processor | CLM-405720 → UHC-12590-72 (Mary Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006967 | Orphan claim re-pointed Claims processor | CLM-417295 → UHC-06610-34 (Brittany Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006968 | Orphan claim re-pointed Claims processor | CLM-401762 → UHC-44925-24 (Bradley Gilbet) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006969 | Orphan claim re-pointed Claims processor | CLM-414329 → UHC-75183-23 (Bobby Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006970 | Orphan claim re-pointed Claims processor | CLM-419407 → UHC-41975-39 (Mary Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006971 | Orphan claim re-pointed Claims processor | CLM-425068 → UHC-52069-26 (Eric Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006972 | Orphan claim re-pointed Claims processor | CLM-430851 → UHC-97369-50 (Gabriel Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006973 | Orphan claim re-pointed Claims processor | CLM-411977 → UHC-40282-62 (Frank Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006974 | Orphan claim re-pointed Claims processor | CLM-424476 → UHC-55479-79 (Diana Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006975 | Orphan claim re-pointed Claims processor | CLM-422895 → UHC-46475-46 (Austin Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006976 | Orphan claim re-pointed Claims processor | CLM-417743 → UHC-87202-79 (Bryan Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006977 | Orphan claim re-pointed Claims processor | CLM-403389 → UHC-33506-03 (Brian Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006978 | Orphan claim re-pointed Claims processor | CLM-431069 → UHC-27450-46 (Kayla Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006979 | Orphan claim re-pointed Claims processor | CLM-428874 → UHC-37584-31 (Jean Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006980 | Orphan claim re-pointed Claims processor | CLM-413322 → UHC-06114-93 (Nancy Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006981 | Orphan claim re-pointed Claims processor | CLM-419688 → UHC-57924-23 (Ryan Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006982 | Orphan claim re-pointed Claims processor | CLM-424968 → UHC-21100-34 (Joseph Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006983 | Orphan claim re-pointed Claims processor | CLM-408489 → UHC-54352-44 (Madison Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006984 | Orphan claim re-pointed Claims processor | CLM-410792 → UHC-40739-50 (Julie Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006985 | Orphan claim re-pointed Claims processor | CLM-413119 → UHC-69924-78 (Yuki Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006986 | Orphan claim re-pointed Claims processor | CLM-424111 → UHC-73006-67 (Doris Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006987 | Orphan claim re-pointed Claims processor | CLM-426353 → UHC-51163-84 (Maria Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006988 | Orphan claim re-pointed Claims processor | CLM-418278 → UHC-08748-12 (Robetr Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006989 | Orphan claim re-pointed Claims processor | CLM-404408 → UHC-78331-45 (Matthew White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006990 | Orphan claim re-pointed Claims processor | CLM-412710 → UHC-17679-69 (Randy Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006991 | Orphan claim re-pointed Claims processor | CLM-408484 → UHC-71172-51 (Ralph Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006992 | Orphan claim re-pointed Claims processor | CLM-427642 → UHC-57924-01 (Shirley Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006993 | Orphan claim re-pointed Claims processor | CLM-413166 → UHC-58593-18 (Logan Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006994 | Orphan claim re-pointed Claims processor | CLM-413264 → UHC-95705-04 (Willie Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006995 | Orphan claim re-pointed Claims processor | CLM-417943 → UHC-87700-61 (Ryan Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006996 | Orphan claim re-pointed Claims processor | CLM-418823 → UHC-20624-46 (Bruce Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006997 | Orphan claim re-pointed Claims processor | CLM-404491 → UHC-32520-91 (Jonathan Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006998 | Orphan claim re-pointed Claims processor | CLM-428516 → UHC-40621-41 (Scott Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006999 | Orphan claim re-pointed Claims processor | CLM-400763 → UHC-23266-84 (Billy Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007000 | Orphan claim re-pointed Claims processor | CLM-428466 → UHC-22551-06 (Laura Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007001 | Orphan claim re-pointed Claims processor | CLM-421466 → UHC-09837-69 (Karen Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007002 | Orphan claim re-pointed Claims processor | CLM-411577 → UHC-86063-13 (Ahmed Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007003 | Orphan claim re-pointed Claims processor | CLM-422494 → UHC-43524-49 (Rachel Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007004 | Orphan claim re-pointed Claims processor | CLM-426052 → UHC-95033-99 (Carlos Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007005 | Orphan claim re-pointed Claims processor | CLM-431195 → UHC-46380-98 (Timothy Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007006 | Orphan claim re-pointed Claims processor | CLM-419900 → UHC-69124-67 (Kathryn Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007007 | Orphan claim re-pointed Claims processor | CLM-427994 → UHC-68499-83 (Jose Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007008 | Orphan claim re-pointed Claims processor | CLM-427157 → UHC-26241-69 (Donald Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007009 | Orphan claim re-pointed Claims processor | CLM-412042 → UHC-26200-71 (Jonathan McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007010 | Orphan claim re-pointed Claims processor | CLM-424416 → UHC-85600-23 (Noah Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007011 | Orphan claim re-pointed Claims processor | CLM-400211 → UHC-96143-73 (Brandon Bennett) |
| 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.