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-007262 | Orphan claim re-pointed Claims processor | CLM-409119 → UHC-44075-78 (Joe Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007263 | Orphan claim re-pointed Claims processor | CLM-413835 → UHC-41599-44 (Sean Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007264 | Orphan claim re-pointed Claims processor | CLM-408406 → UHC-34872-28 (Marilyn Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007265 | Orphan claim re-pointed Claims processor | CLM-428291 → UHC-42317-04 (Hannah Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007266 | Orphan claim re-pointed Claims processor | CLM-405347 → UHC-54937-27 (Bryan Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007267 | Orphan claim re-pointed Claims processor | CLM-428614 → UHC-45580-06 (Andrea Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007268 | Orphan claim re-pointed Claims processor | CLM-409982 → UHC-00347-08 (Stephen McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007269 | Orphan claim re-pointed Claims processor | CLM-417946 → UHC-16646-65 (Kevin Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007270 | Orphan claim re-pointed Claims processor | CLM-420433 → UHC-96057-46 (Helen Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007271 | Orphan claim re-pointed Claims processor | CLM-429333 → UHC-82530-02 (Barbara Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007272 | Orphan claim re-pointed Claims processor | CLM-432252 → UHC-95527-11 (Catherine Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007273 | Orphan claim re-pointed Claims processor | CLM-423436 → UHC-53888-91 (Brittany Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007274 | Orphan claim re-pointed Claims processor | CLM-424032 → UHC-45400-47 (Megan Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007275 | Orphan claim re-pointed Claims processor | CLM-402719 → UHC-36910-73 (Marcus Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007276 | Orphan claim re-pointed Claims processor | CLM-404430 → UHC-89708-54 (Jonathan Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007277 | Orphan claim re-pointed Claims processor | CLM-423449 → UHC-88391-59 (Lauren Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007278 | Orphan claim re-pointed Claims processor | CLM-428014 → UHC-08220-88 (Terry Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007279 | Orphan claim re-pointed Claims processor | CLM-409135 → UHC-69964-16 (Jacqueline Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007280 | Orphan claim re-pointed Claims processor | CLM-415868 → UHC-03787-87 (Noah Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007281 | Orphan claim re-pointed Claims processor | CLM-403524 → UHC-31813-40 (Joseph Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007282 | Orphan claim re-pointed Claims processor | CLM-428310 → UHC-89807-12 (Joseph Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007283 | Orphan claim re-pointed Claims processor | CLM-416020 → UHC-49073-83 (Fatima Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007284 | Orphan claim re-pointed Claims processor | CLM-418396 → UHC-84939-80 (Helen Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007285 | Orphan claim re-pointed Claims processor | CLM-414377 → UHC-99048-06 (Luis Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007286 | Orphan claim re-pointed Claims processor | CLM-419545 → UHC-63508-30 (Zachary Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007287 | Orphan claim re-pointed Claims processor | CLM-418804 → UHC-16032-64 (Melissa Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007288 | Orphan claim re-pointed Claims processor | CLM-402325 → UHC-19887-42 (Sophia Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007289 | Orphan claim re-pointed Claims processor | CLM-432653 → UHC-21594-17 (Stephen Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007290 | Orphan claim re-pointed Claims processor | CLM-404794 → UHC-96131-84 (Patrick Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007291 | Orphan claim re-pointed Claims processor | CLM-421822 → UHC-11214-95 (Jeffrey Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007292 | Orphan claim re-pointed Claims processor | CLM-432373 → UHC-12963-51 (Debra Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007293 | Orphan claim re-pointed Claims processor | CLM-428198 → UHC-05897-89 (Jesse Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007294 | Orphan claim re-pointed Claims processor | CLM-404025 → UHC-59897-08 (Katherine Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007295 | Orphan claim re-pointed Claims processor | CLM-404532 → UHC-53774-63 (Hiroshi Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007296 | Orphan claim re-pointed Claims processor | CLM-422834 → UHC-10956-01 (Jacqueline Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007297 | Orphan claim re-pointed Claims processor | CLM-418456 → UHC-38729-59 (Gabriel Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007298 | Orphan claim re-pointed Claims processor | CLM-432451 → UHC-89494-51 (Catherine Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007299 | Orphan claim re-pointed Claims processor | CLM-415421 → UHC-81737-68 (Brittany Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007300 | Orphan claim re-pointed Claims processor | CLM-427611 → UHC-30630-78 (Margaret Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007301 | Orphan claim re-pointed Claims processor | CLM-423269 → UHC-22787-33 (Brittany Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007302 | Orphan claim re-pointed Claims processor | CLM-430558 → UHC-79512-66 (Valentina Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007303 | Orphan claim re-pointed Claims processor | CLM-429716 → UHC-22561-29 (Laura Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007304 | Orphan claim re-pointed Claims processor | CLM-410501 → UHC-66139-13 (Christian Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007305 | Orphan claim re-pointed Claims processor | CLM-414217 → UHC-83009-59 (Helen Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007306 | Orphan claim re-pointed Claims processor | CLM-404336 → UHC-10602-08 (Kyle Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007307 | Orphan claim re-pointed Claims processor | CLM-424021 → UHC-58273-21 (Mike Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007308 | Orphan claim re-pointed Claims processor | CLM-430559 → UHC-79512-66 (Valentina Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007309 | Orphan claim re-pointed Claims processor | CLM-420650 → UHC-96665-83 (Megan Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007310 | Orphan claim re-pointed Claims processor | CLM-408155 → UHC-15522-20 (Elijah Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007311 | Orphan claim re-pointed Claims processor | CLM-415046 → UHC-74879-57 (Nataliie Cox) |
| 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.