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-007212 | Orphan claim re-pointed Claims processor | CLM-403634 → UHC-90506-25 (Henry Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007213 | Orphan claim re-pointed Claims processor | CLM-428470 → UHC-21156-85 (Cheryl Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007214 | Orphan claim re-pointed Claims processor | CLM-415575 → UHC-40367-98 (Samuel Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007215 | Orphan claim re-pointed Claims processor | CLM-430812 → UHC-64482-19 (Keith Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007216 | Orphan claim re-pointed Claims processor | CLM-401544 → UHC-12016-86 (Heahter Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007217 | Orphan claim re-pointed Claims processor | CLM-419378 → UHC-85432-06 (Albert Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007218 | Orphan claim re-pointed Claims processor | CLM-408544 → UHC-62640-51 (Jean Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007219 | Orphan claim re-pointed Claims processor | CLM-405308 → UHC-78551-20 (Jesse Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007220 | Orphan claim re-pointed Claims processor | CLM-405336 → UHC-74665-73 (Henry Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007221 | Orphan claim re-pointed Claims processor | CLM-418829 → UHC-30285-90 (Heather Moarles) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007222 | Orphan claim re-pointed Claims processor | CLM-428864 → UHC-52773-50 (Teresa Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007223 | Orphan claim re-pointed Claims processor | CLM-410754 → UHC-44037-64 (Jordan George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007224 | Orphan claim re-pointed Claims processor | CLM-400123 → UHC-27224-84 (Betty Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007225 | Orphan claim re-pointed Claims processor | CLM-410954 → UHC-53705-72 (Noah Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007226 | Orphan claim re-pointed Claims processor | CLM-431743 → UHC-36385-95 (Judith Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007227 | Orphan claim re-pointed Claims processor | CLM-426080 → UHC-13514-35 (Mason Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007228 | Orphan claim re-pointed Claims processor | CLM-423074 → UHC-62601-51 (Shirley Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007229 | Orphan claim re-pointed Claims processor | CLM-402275 → UHC-96313-13 (Nicole Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007230 | Orphan claim re-pointed Claims processor | CLM-412757 → UHC-23865-08 (Justin Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007231 | Orphan claim re-pointed Claims processor | CLM-424104 → UHC-36356-27 (Edward George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007232 | Orphan claim re-pointed Claims processor | CLM-409542 → UHC-49632-09 (Mark Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007233 | Orphan claim re-pointed Claims processor | CLM-409696 → UHC-88199-27 (Carlos Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007234 | Orphan claim re-pointed Claims processor | CLM-414717 → UHC-58402-80 (Brandon Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007235 | Orphan claim re-pointed Claims processor | CLM-421731 → UHC-49623-35 (Carlos Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007236 | Orphan claim re-pointed Claims processor | CLM-426677 → UHC-94994-59 (Betty Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007237 | Orphan claim re-pointed Claims processor | CLM-416995 → UHC-92544-37 (William Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007238 | Orphan claim re-pointed Claims processor | CLM-403510 → UHC-12229-41 (Danielle Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007239 | Orphan claim re-pointed Claims processor | CLM-428022 → UHC-05111-02 (Anthony Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007240 | Orphan claim re-pointed Claims processor | CLM-420651 → UHC-40318-84 (Christopher Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007241 | Orphan claim re-pointed Claims processor | CLM-409338 → UHC-15649-07 (Bryan Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007242 | Orphan claim re-pointed Claims processor | CLM-405738 → UHC-43823-71 (Bobby Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007243 | Orphan claim re-pointed Claims processor | CLM-407814 → UHC-02276-61 (Diane Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007244 | Orphan claim re-pointed Claims processor | CLM-401451 → UHC-43441-53 (Melissa Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007245 | Orphan claim re-pointed Claims processor | CLM-424994 → UHC-92278-25 (Alice Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007246 | Orphan claim re-pointed Claims processor | CLM-427573 → UHC-49113-42 (Santiago Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007247 | Orphan claim re-pointed Claims processor | CLM-424644 → UHC-26763-55 (Vincent Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007248 | Orphan claim re-pointed Claims processor | CLM-429783 → UHC-40362-42 (Vincent Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007249 | Orphan claim re-pointed Claims processor | CLM-404087 → UHC-35512-91 (Jonathan Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007250 | Orphan claim re-pointed Claims processor | CLM-419522 → UHC-85777-05 (Peter Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007251 | Orphan claim re-pointed Claims processor | CLM-409586 → UHC-01231-40 (Keith Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007252 | Orphan claim re-pointed Claims processor | CLM-419275 → UHC-51195-87 (Kelly Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007253 | Orphan claim re-pointed Claims processor | CLM-407070 → UHC-85413-02 (Kayla Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007254 | Orphan claim re-pointed Claims processor | CLM-405679 → UHC-82490-30 (Cheryl Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007255 | Orphan claim re-pointed Claims processor | CLM-422948 → UHC-40645-66 (Betty Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007256 | Orphan claim re-pointed Claims processor | CLM-403945 → UHC-24074-48 (Yuki Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007257 | Orphan claim re-pointed Claims processor | CLM-419921 → UHC-65965-34 (Douglas Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007258 | Orphan claim re-pointed Claims processor | CLM-413785 → UHC-89247-75 (Evelyn Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007259 | Orphan claim re-pointed Claims processor | CLM-418593 → UHC-97802-47 (Jessica Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007260 | Orphan claim re-pointed Claims processor | CLM-409738 → UHC-80139-48 (Scott Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007261 | Orphan claim re-pointed Claims processor | CLM-424511 → UHC-98583-63 (Bruce Cruz) |
| 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.