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-007362 | Orphan claim re-pointed Claims processor | CLM-412102 → UHC-91457-63 (Ralph Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007363 | Orphan claim re-pointed Claims processor | CLM-409895 → UHC-97886-80 (Christine George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007364 | Orphan claim re-pointed Claims processor | CLM-420489 → UHC-38914-38 (Abigail Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007365 | Orphan claim re-pointed Claims processor | CLM-415876 → UHC-66321-60 (Sharon Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007366 | Orphan claim re-pointed Claims processor | CLM-424689 → UHC-78782-59 (Georeg Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007367 | Orphan claim re-pointed Claims processor | CLM-405012 → UHC-80359-11 (Eugene Roemro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007368 | Orphan claim re-pointed Claims processor | CLM-415608 → UHC-63429-28 (Larry Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007369 | Orphan claim re-pointed Claims processor | CLM-411797 → UHC-63264-85 (Samantha Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007370 | Orphan claim re-pointed Claims processor | CLM-425754 → UHC-92965-83 (Abigail Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007371 | Orphan claim re-pointed Claims processor | CLM-429897 → UHC-38458-94 (Emma Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007372 | Orphan claim re-pointed Claims processor | CLM-418360 → UHC-62516-28 (Dorothy Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007373 | Orphan claim re-pointed Claims processor | CLM-420573 → UHC-16910-17 (Carl Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007374 | Orphan claim re-pointed Claims processor | CLM-412135 → UHC-43606-52 (Roger Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007375 | Orphan claim re-pointed Claims processor | CLM-417786 → UHC-49446-32 (Walter Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007376 | Orphan claim re-pointed Claims processor | CLM-407787 → UHC-57705-65 (Scott Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007377 | Orphan claim re-pointed Claims processor | CLM-400265 → UHC-52389-49 (Charlotte Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007378 | Orphan claim re-pointed Claims processor | CLM-400131 → UHC-55726-01 (Paul Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007379 | Orphan claim re-pointed Claims processor | CLM-423116 → UHC-17723-18 (Samantha Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007380 | Orphan claim re-pointed Claims processor | CLM-409749 → UHC-84376-98 (Isabella Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007381 | Orphan claim re-pointed Claims processor | CLM-413414 → UHC-95837-67 (Pamela Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007382 | Orphan claim re-pointed Claims processor | CLM-406703 → UHC-66427-98 (Laura Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007383 | Orphan claim re-pointed Claims processor | CLM-414075 → UHC-33882-58 (Christina Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007384 | Orphan claim re-pointed Claims processor | CLM-413229 → UHC-12296-96 (Omar Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007385 | Orphan claim re-pointed Claims processor | CLM-408486 → UHC-39625-55 (Philip Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007386 | Orphan claim re-pointed Claims processor | CLM-403020 → UHC-13925-39 (Willie Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007387 | Orphan claim re-pointed Claims processor | CLM-405103 → UHC-56374-38 (Arthur Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007388 | Orphan claim re-pointed Claims processor | CLM-400770 → UHC-07023-35 (Alex Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007389 | Orphan claim re-pointed Claims processor | CLM-425668 → UHC-81998-51 (Angela Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007390 | Orphan claim re-pointed Claims processor | CLM-425442 → UHC-08833-43 (Kimberly Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007391 | Orphan claim re-pointed Claims processor | CLM-414572 → UHC-61400-78 (Laura Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007392 | Orphan claim re-pointed Claims processor | CLM-407741 → UHC-33242-35 (Ronald Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007393 | Orphan claim re-pointed Claims processor | CLM-430478 → UHC-43570-25 (Nicholas Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007394 | Orphan claim re-pointed Claims processor | CLM-420930 → UHC-14343-17 (Theresa Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007395 | Orphan claim re-pointed Claims processor | CLM-419532 → UHC-72930-75 (Jack Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007396 | Orphan claim re-pointed Claims processor | CLM-424225 → UHC-20658-44 (Jesse Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007397 | Orphan claim re-pointed Claims processor | CLM-409325 → UHC-49656-02 (Karen Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007398 | Orphan claim re-pointed Claims processor | CLM-421523 → UHC-18643-63 (Susan Maldoando) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007399 | Orphan claim re-pointed Claims processor | CLM-414714 → UHC-82922-67 (Jack Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007400 | Orphan claim re-pointed Claims processor | CLM-406037 → UHC-76599-05 (Larry Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007401 | Orphan claim re-pointed Claims processor | CLM-432648 → UHC-18180-64 (Priya Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007402 | Orphan claim re-pointed Claims processor | CLM-404257 → UHC-66211-76 (Bobby Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007403 | Orphan claim re-pointed Claims processor | CLM-408576 → UHC-21475-31 (Marilyn Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007404 | Orphan claim re-pointed Claims processor | CLM-408354 → UHC-74337-10 (Ahmed Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007405 | Orphan claim re-pointed Claims processor | CLM-427278 → UHC-08811-16 (Harold Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007406 | Orphan claim re-pointed Claims processor | CLM-430477 → UHC-58815-25 (Vincent Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007407 | Orphan claim re-pointed Claims processor | CLM-403581 → UHC-37893-53 (Frank Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007408 | Orphan claim re-pointed Claims processor | CLM-407187 → UHC-52970-96 (Linda Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007409 | Orphan claim re-pointed Claims processor | CLM-403620 → UHC-50184-15 (Brandon Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007410 | Orphan claim re-pointed Claims processor | CLM-402818 → UHC-31356-88 (Elizabeth Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007411 | Orphan claim re-pointed Claims processor | CLM-423191 → UHC-52920-63 (Jesse Armstrong) |
| 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.