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-007012 | Orphan claim re-pointed Claims processor | CLM-422151 → UHC-85301-17 (Jason Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007013 | Orphan claim re-pointed Claims processor | CLM-410870 → UHC-84632-41 (Gerald Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007014 | Orphan claim re-pointed Claims processor | CLM-400362 → UHC-69655-07 (Eric Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007015 | Orphan claim re-pointed Claims processor | CLM-429931 → UHC-43150-75 (Amy Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007016 | Orphan claim re-pointed Claims processor | CLM-406496 → UHC-54871-91 (Omar Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007017 | Orphan claim re-pointed Claims processor | CLM-429483 → UHC-15796-58 (Stephen King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007018 | Orphan claim re-pointed Claims processor | CLM-420116 → UHC-36493-03 (Jose Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007019 | Orphan claim re-pointed Claims processor | CLM-420487 → UHC-68721-38 (Jose Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007020 | Orphan claim re-pointed Claims processor | CLM-423708 → UHC-22282-57 (Joyce Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007021 | Orphan claim re-pointed Claims processor | CLM-432161 → UHC-59494-89 (Linda Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007022 | Orphan claim re-pointed Claims processor | CLM-424666 → UHC-60560-81 (Alice Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007023 | Orphan claim re-pointed Claims processor | CLM-409977 → UHC-24326-31 (Priya Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007024 | Orphan claim re-pointed Claims processor | CLM-405234 → UHC-52836-55 (Victoria Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007025 | Orphan claim re-pointed Claims processor | CLM-406464 → UHC-73695-03 (Kathleen Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007026 | Orphan claim re-pointed Claims processor | CLM-413126 → UHC-33748-51 (Frank Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007027 | Orphan claim re-pointed Claims processor | CLM-404649 → UHC-13806-99 (Mary Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007028 | Orphan claim re-pointed Claims processor | CLM-422135 → UHC-73040-31 (Kevin Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007029 | Orphan claim re-pointed Claims processor | CLM-421764 → UHC-69098-58 (Laura Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007030 | Orphan claim re-pointed Claims processor | CLM-421966 → UHC-17502-07 (Jeffrey Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007031 | Orphan claim re-pointed Claims processor | CLM-409139 → UHC-74963-28 (Bruce Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007032 | Orphan claim re-pointed Claims processor | CLM-413910 → UHC-66169-12 (Paul Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007033 | Orphan claim re-pointed Claims processor | CLM-420616 → UHC-01722-15 (Jonathan Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007034 | Orphan claim re-pointed Claims processor | CLM-418915 → UHC-07852-29 (Stephanie Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007035 | Orphan claim re-pointed Claims processor | CLM-420108 → UHC-36357-55 (Nicholas Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007036 | Orphan claim re-pointed Claims processor | CLM-406741 → UHC-82015-88 (Ana Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007037 | Orphan claim re-pointed Claims processor | CLM-413260 → UHC-23765-47 (Karen Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007038 | Orphan claim re-pointed Claims processor | CLM-419707 → UHC-34608-53 (Marilyn James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007039 | Orphan claim re-pointed Claims processor | CLM-422054 → UHC-47146-64 (Sara Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007040 | Orphan claim re-pointed Claims processor | CLM-402787 → UHC-03439-03 (Luis Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007041 | Orphan claim re-pointed Claims processor | CLM-425184 → UHC-46251-68 (Deborah Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007042 | Orphan claim re-pointed Claims processor | CLM-419971 → UHC-60192-48 (Emma Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007043 | Orphan claim re-pointed Claims processor | CLM-421263 → UHC-68395-91 (Randy Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007044 | Orphan claim re-pointed Claims processor | CLM-416810 → UHC-33256-68 (Peter Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007045 | Orphan claim re-pointed Claims processor | CLM-428799 → UHC-60979-31 (Russell Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007046 | Orphan claim re-pointed Claims processor | CLM-402549 → UHC-77309-19 (Diana Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007047 | Orphan claim re-pointed Claims processor | CLM-415099 → UHC-19125-53 (Emily Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007048 | Orphan claim re-pointed Claims processor | CLM-401986 → UHC-73453-17 (Stephanie Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007049 | Orphan claim re-pointed Claims processor | CLM-406660 → UHC-51288-35 (Joyce Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007050 | Orphan claim re-pointed Claims processor | CLM-418445 → UHC-87872-07 (Martha Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007051 | Orphan claim re-pointed Claims processor | CLM-426642 → UHC-93715-49 (Nancy Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007052 | Orphan claim re-pointed Claims processor | CLM-408588 → UHC-19807-30 (Joshua Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007053 | Orphan claim re-pointed Claims processor | CLM-409381 → UHC-22854-38 (Anna Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007054 | Orphan claim re-pointed Claims processor | CLM-409308 → UHC-85666-65 (Wayne Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007055 | Orphan claim re-pointed Claims processor | CLM-414413 → UHC-35265-34 (Bobby Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007056 | Orphan claim re-pointed Claims processor | CLM-402596 → UHC-52002-05 (Patricia Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007057 | Orphan claim re-pointed Claims processor | CLM-420318 → UHC-91446-36 (Gary Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007058 | Orphan claim re-pointed Claims processor | CLM-415036 → UHC-43336-64 (Keith Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007059 | Orphan claim re-pointed Claims processor | CLM-432296 → UHC-89122-31 (David Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007060 | Orphan claim re-pointed Claims processor | CLM-419341 → UHC-94105-73 (Richard Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007061 | Orphan claim re-pointed Claims processor | CLM-402751 → UHC-75257-74 (George Knight) |
| 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.