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-007412 | Orphan claim re-pointed Claims processor | CLM-423586 → UHC-21655-74 (Victoria Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007413 | Orphan claim re-pointed Claims processor | CLM-413026 → UHC-98078-99 (Kayla Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007414 | Orphan claim re-pointed Claims processor | CLM-421542 → UHC-49353-13 (Ruth Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007415 | Orphan claim re-pointed Claims processor | CLM-430263 → UHC-70241-02 (Gabriel Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007416 | Orphan claim re-pointed Claims processor | CLM-411079 → UHC-87096-87 (Kayyla Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007417 | Orphan claim re-pointed Claims processor | CLM-413666 → UHC-79852-64 (Santiago McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007418 | Orphan claim re-pointed Claims processor | CLM-402909 → UHC-43711-15 (Hiroshi Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007419 | Orphan claim re-pointed Claims processor | CLM-431369 → UHC-41025-03 (William Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007420 | Orphan claim re-pointed Claims processor | CLM-413281 → UHC-95145-59 (Gabriel Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007421 | Orphan claim re-pointed Claims processor | CLM-410144 → UHC-63728-04 (William Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007422 | Orphan claim re-pointed Claims processor | CLM-427247 → UHC-50874-41 (Bruce Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007423 | Orphan claim re-pointed Claims processor | CLM-411206 → UHC-80098-32 (Helen Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007424 | Orphan claim re-pointed Claims processor | CLM-403118 → UHC-86325-71 (Doris Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007425 | Orphan claim re-pointed Claims processor | CLM-412326 → UHC-78189-72 (Juan Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007426 | Orphan claim re-pointed Claims processor | CLM-425533 → UHC-34426-64 (Logan Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007427 | Orphan claim re-pointed Claims processor | CLM-420712 → UHC-11585-25 (Dennis Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007428 | Orphan claim re-pointed Claims processor | CLM-412641 → UHC-66069-07 (Olivia Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007429 | Orphan claim re-pointed Claims processor | CLM-427022 → UHC-78014-98 (Natalie Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007430 | Orphan claim re-pointed Claims processor | CLM-422877 → UHC-06888-45 (Hnanah Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007431 | Orphan claim re-pointed Claims processor | CLM-424955 → UHC-21076-40 (Angela Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007432 | Orphan claim re-pointed Claims processor | CLM-410342 → UHC-31741-46 (Megan Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007433 | Orphan claim re-pointed Claims processor | CLM-405023 → UHC-94020-81 (Willie Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007434 | Orphan claim re-pointed Claims processor | CLM-411369 → UHC-53597-96 (Diana Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007435 | Orphan claim re-pointed Claims processor | CLM-406516 → UHC-58654-72 (Virginia Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007436 | Orphan claim re-pointed Claims processor | CLM-409428 → UHC-43731-30 (Nancy Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007437 | Orphan claim re-pointed Claims processor | CLM-402773 → UHC-81830-53 (Gabriel Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007438 | Orphan claim re-pointed Claims processor | CLM-427237 → UHC-12535-13 (Joseph Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007439 | Orphan claim re-pointed Claims processor | CLM-400968 → UHC-57320-39 (Santiago Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007440 | Orphan claim re-pointed Claims processor | CLM-432633 → UHC-06260-45 (Mateo Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007441 | Orphan claim re-pointed Claims processor | CLM-429183 → UHC-38196-25 (Jennifer Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007442 | Orphan claim re-pointed Claims processor | CLM-401057 → UHC-14949-45 (Billy Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007443 | Orphan claim re-pointed Claims processor | CLM-411840 → UHC-25205-29 (Theresa Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007444 | Orphan claim re-pointed Claims processor | CLM-420548 → UHC-68314-07 (Tyler Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007445 | Orphan claim re-pointed Claims processor | CLM-420059 → UHC-22457-29 (Christina Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007446 | Orphan claim re-pointed Claims processor | CLM-429071 → UHC-82889-88 (Charlotte Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007447 | Orphan claim re-pointed Claims processor | CLM-407156 → UHC-29736-17 (Susan Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007448 | Orphan claim re-pointed Claims processor | CLM-415830 → UHC-32513-52 (Gabriel Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007449 | Orphan claim re-pointed Claims processor | CLM-415874 → UHC-14307-75 (Judy Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007450 | Orphan claim re-pointed Claims processor | CLM-400677 → UHC-23542-94 (Catherine Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007451 | Orphan claim re-pointed Claims processor | CLM-404757 → UHC-82310-03 (Jesse Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007452 | Orphan claim re-pointed Claims processor | CLM-408313 → UHC-29708-97 (Tyler Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007453 | Orphan claim re-pointed Claims processor | CLM-427798 → UHC-36837-08 (Fox Tom) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007454 | Orphan claim re-pointed Claims processor | CLM-427060 → UHC-34285-94 (Amanda Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007455 | Orphan claim re-pointed Claims processor | CLM-413815 → UHC-28795-61 (Nancy Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007456 | Orphan claim re-pointed Claims processor | CLM-417656 → UHC-07938-13 (Matthew Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007457 | Orphan claim re-pointed Claims processor | CLM-422934 → UHC-69116-90 (Sara Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007458 | Orphan claim re-pointed Claims processor | CLM-411942 → UHC-47269-70 (Gloria Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007459 | Orphan claim re-pointed Claims processor | CLM-418911 → UHC-72531-64 (Camila Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007460 | Orphan claim re-pointed Claims processor | CLM-420226 → UHC-34636-62 (Raymond Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007461 | Orphan claim re-pointed Claims processor | CLM-431202 → UHC-59050-84 (Bradley Jones) |
| 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.