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-007162 | Orphan claim re-pointed Claims processor | CLM-431314 → UHC-94844-47 (Joshua Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007163 | Orphan claim re-pointed Claims processor | CLM-410922 → UHC-67960-13 (Dylan Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007164 | Orphan claim re-pointed Claims processor | CLM-416398 → UHC-37033-56 (Logan Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007165 | Orphan claim re-pointed Claims processor | CLM-424661 → UHC-50017-20 (Henry Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007166 | Orphan claim re-pointed Claims processor | CLM-426737 → UHC-09236-74 (Juan Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007167 | Orphan claim re-pointed Claims processor | CLM-417057 → UHC-92848-17 (Lauren Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007168 | Orphan claim re-pointed Claims processor | CLM-420580 → UHC-97273-56 (Sandra Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007169 | Orphan claim re-pointed Claims processor | CLM-404845 → UHC-47377-58 (Joseph Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007170 | Orphan claim re-pointed Claims processor | CLM-417579 → UHC-16030-05 (Henry Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007171 | Orphan claim re-pointed Claims processor | CLM-420293 → UHC-33964-60 (Christian Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007172 | Orphan claim re-pointed Claims processor | CLM-406724 → UHC-04666-05 (Kenneth Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007173 | Orphan claim re-pointed Claims processor | CLM-428802 → UHC-96293-11 (Edward Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007174 | Orphan claim re-pointed Claims processor | CLM-418939 → UHC-28850-11 (Helen Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007175 | Orphan claim re-pointed Claims processor | CLM-425230 → UHC-02912-63 (Bradley Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007176 | Orphan claim re-pointed Claims processor | CLM-420711 → UHC-90571-84 (Kathleen Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007177 | Orphan claim re-pointed Claims processor | CLM-402397 → UHC-29381-35 (Hannah Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007178 | Orphan claim re-pointed Claims processor | CLM-423015 → UHC-11528-25 (Isabella Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007179 | Orphan claim re-pointed Claims processor | CLM-414529 → UHC-91573-67 (Bryan Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007180 | Orphan claim re-pointed Claims processor | CLM-423437 → UHC-21091-76 (Stephen Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007181 | Orphan claim re-pointed Claims processor | CLM-426874 → UHC-95535-50 (Henry Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007182 | Orphan claim re-pointed Claims processor | CLM-411106 → UHC-89861-37 (Nancy Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007183 | Orphan claim re-pointed Claims processor | CLM-407951 → UHC-27499-03 (Rachel Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007184 | Orphan claim re-pointed Claims processor | CLM-404429 → UHC-17367-62 (John Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007185 | Orphan claim re-pointed Claims processor | CLM-404199 → UHC-10156-16 (Debra Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007186 | Orphan claim re-pointed Claims processor | CLM-413134 → UHC-10198-70 (Marilyn Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007187 | Orphan claim re-pointed Claims processor | CLM-411822 → UHC-15101-05 (Vincent Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007188 | Orphan claim re-pointed Claims processor | CLM-417410 → UHC-74389-69 (Robert Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007189 | Orphan claim re-pointed Claims processor | CLM-425680 → UHC-89493-86 (Janet Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007190 | Orphan claim re-pointed Claims processor | CLM-407327 → UHC-41549-61 (Ana Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007191 | Orphan claim re-pointed Claims processor | CLM-423961 → UHC-36576-92 (Aisha Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007192 | Orphan claim re-pointed Claims processor | CLM-432119 → UHC-67652-54 (Mateo Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007193 | Orphan claim re-pointed Claims processor | CLM-426852 → UHC-25529-53 (Aaron Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007194 | Orphan claim re-pointed Claims processor | CLM-413528 → UHC-81231-41 (Valentina Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007195 | Orphan claim re-pointed Claims processor | CLM-409398 → UHC-96013-13 (Stephen Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007196 | Orphan claim re-pointed Claims processor | CLM-432194 → UHC-92339-35 (Joe Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007197 | Orphan claim re-pointed Claims processor | CLM-421579 → UHC-75772-33 (Michael Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007198 | Orphan claim re-pointed Claims processor | CLM-414820 → UHC-01868-34 (Austin Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007199 | Orphan claim re-pointed Claims processor | CLM-425414 → UHC-05438-97 (Sean Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007200 | Orphan claim re-pointed Claims processor | CLM-422821 → UHC-00925-87 (Jonathan Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007201 | Orphan claim re-pointed Claims processor | CLM-429995 → UHC-56997-24 (Ashley Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007202 | Orphan claim re-pointed Claims processor | CLM-409499 → UHC-29658-63 (Russell Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007203 | Orphan claim re-pointed Claims processor | CLM-407217 → UHC-67186-14 (Theresa Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007204 | Orphan claim re-pointed Claims processor | CLM-423505 → UHC-06958-08 (Judith Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007205 | Orphan claim re-pointed Claims processor | CLM-426372 → UHC-10097-24 (Sharon Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007206 | Orphan claim re-pointed Claims processor | CLM-424495 → UHC-20697-04 (Carol Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007207 | Orphan claim re-pointed Claims processor | CLM-402016 → UHC-66052-13 (Raymond Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007208 | Orphan claim re-pointed Claims processor | CLM-402853 → UHC-34396-45 (Martha Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007209 | Orphan claim re-pointed Claims processor | CLM-422101 → UHC-28896-64 (Isabella Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007210 | Orphan claim re-pointed Claims processor | CLM-426053 → UHC-07093-42 (Luis Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007211 | Orphan claim re-pointed Claims processor | CLM-430756 → UHC-14087-46 (Jerry 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.