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-007312 | Orphan claim re-pointed Claims processor | CLM-414440 → UHC-64017-72 (Evelyn Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007313 | Orphan claim re-pointed Claims processor | CLM-414294 → UHC-05912-11 (Camila Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007314 | Orphan claim re-pointed Claims processor | CLM-415361 → UHC-47531-91 (Ruth West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007315 | Orphan claim re-pointed Claims processor | CLM-404926 → UHC-37349-81 (Jon McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007316 | Orphan claim re-pointed Claims processor | CLM-404017 → UHC-95780-81 (Betty Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007317 | Orphan claim re-pointed Claims processor | CLM-407170 → UHC-65344-16 (Nicholas Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007318 | Orphan claim re-pointed Claims processor | CLM-428772 → UHC-13234-84 (Arthur Martinnez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007319 | Orphan claim re-pointed Claims processor | CLM-423551 → UHC-97296-45 (Doris Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007320 | Orphan claim re-pointed Claims processor | CLM-431128 → UHC-22904-19 (Sarah Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007321 | Orphan claim re-pointed Claims processor | CLM-427132 → UHC-42284-52 (Nathan Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007322 | Orphan claim re-pointed Claims processor | CLM-405030 → UHC-92637-64 (Christopher Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007323 | Orphan claim re-pointed Claims processor | CLM-428672 → UHC-07231-79 (Jordan Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007324 | Orphan claim re-pointed Claims processor | CLM-428602 → UHC-94886-33 (Aisha Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007325 | Orphan claim re-pointed Claims processor | CLM-431396 → UHC-17996-45 (Michelle Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007326 | Orphan claim re-pointed Claims processor | CLM-412756 → UHC-89231-52 (Wayne Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007327 | Orphan claim re-pointed Claims processor | CLM-404310 → UHC-16993-83 (Jacqueline Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007328 | Orphan claim re-pointed Claims processor | CLM-423733 → UHC-27605-62 (Luis Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007329 | Orphan claim re-pointed Claims processor | CLM-409301 → UHC-53249-64 (Nataliie Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007330 | Orphan claim re-pointed Claims processor | CLM-427665 → UHC-65598-14 (Alexis Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007331 | Orphan claim re-pointed Claims processor | CLM-419043 → UHC-62284-61 (Karen Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007332 | Orphan claim re-pointed Claims processor | CLM-414327 → UHC-17982-74 (Theresa Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007333 | Orphan claim re-pointed Claims processor | CLM-432060 → UHC-26627-21 (Mariana Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007334 | Orphan claim re-pointed Claims processor | CLM-421932 → UHC-83588-76 (Maria Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007335 | Orphan claim re-pointed Claims processor | CLM-414178 → UHC-92165-97 (Elizabeth Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007336 | Orphan claim re-pointed Claims processor | CLM-414035 → UHC-13671-78 (Christine Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007337 | Orphan claim re-pointed Claims processor | CLM-413019 → UHC-70320-01 (Juan Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007338 | Orphan claim re-pointed Claims processor | CLM-401857 → UHC-50709-05 (Samuel Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007339 | Orphan claim re-pointed Claims processor | CLM-423883 → UHC-20161-23 (Diana Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007340 | Orphan claim re-pointed Claims processor | CLM-428952 → UHC-11050-43 (Lori Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007341 | Orphan claim re-pointed Claims processor | CLM-406129 → UHC-67914-70 (Benjamin Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007342 | Orphan claim re-pointed Claims processor | CLM-414355 → UHC-04909-22 (Rebecca Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007343 | Orphan claim re-pointed Claims processor | CLM-415050 → UHC-69500-16 (Vincent Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007344 | Orphan claim re-pointed Claims processor | CLM-403326 → UHC-87519-98 (Helen Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007345 | Orphan claim re-pointed Claims processor | CLM-432146 → UHC-52291-89 (Donna Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007346 | Orphan claim re-pointed Claims processor | CLM-402531 → UHC-02095-60 (Carl Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007347 | Orphan claim re-pointed Claims processor | CLM-417810 → UHC-98053-18 (Donna Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007348 | Orphan claim re-pointed Claims processor | CLM-418294 → UHC-60893-02 (Jonathan Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007349 | Orphan claim re-pointed Claims processor | CLM-430908 → UHC-68169-21 (Jose Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007350 | Orphan claim re-pointed Claims processor | CLM-410328 → UHC-10708-73 (Brian Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007351 | Orphan claim re-pointed Claims processor | CLM-410834 → UHC-51902-38 (Albert Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007352 | Orphan claim re-pointed Claims processor | CLM-421641 → UHC-37745-14 (Sarah Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007353 | Orphan claim re-pointed Claims processor | CLM-409200 → UHC-78709-34 (Angela Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007354 | Orphan claim re-pointed Claims processor | CLM-404301 → UHC-54477-15 (Eugene Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007355 | Orphan claim re-pointed Claims processor | CLM-430600 → UHC-08712-31 (Willie Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007356 | Orphan claim re-pointed Claims processor | CLM-408927 → UHC-23202-90 (Paul Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007357 | Orphan claim re-pointed Claims processor | CLM-410087 → UHC-62092-10 (Helen Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007358 | Orphan claim re-pointed Claims processor | CLM-414856 → UHC-12549-84 (Donald Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007359 | Orphan claim re-pointed Claims processor | CLM-412901 → UHC-21901-22 (Amy Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007360 | Orphan claim re-pointed Claims processor | CLM-400655 → UHC-80721-02 (Paul Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007361 | Orphan claim re-pointed Claims processor | CLM-423068 → UHC-63082-94 (Dennis Phillips) |
| 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.