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-007462 | Orphan claim re-pointed Claims processor | CLM-421644 → UHC-46097-50 (Santiago Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007463 | Orphan claim re-pointed Claims processor | CLM-414450 → UHC-62343-53 (Ashley Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007464 | Orphan claim re-pointed Claims processor | CLM-430515 → UHC-24394-15 (Sara Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007465 | Orphan claim re-pointed Claims processor | CLM-404499 → UHC-64045-83 (Gregory Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007466 | Orphan claim re-pointed Claims processor | CLM-412932 → UHC-89676-44 (Nicholas Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007467 | Orphan claim re-pointed Claims processor | CLM-404741 → UHC-89522-53 (Lisa Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007468 | Orphan claim re-pointed Claims processor | CLM-408090 → UHC-11947-28 (Hiroshi Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007469 | Orphan claim re-pointed Claims processor | CLM-428865 → UHC-07566-18 (Christopher Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007470 | Orphan claim re-pointed Claims processor | CLM-423871 → UHC-59566-95 (Lauren Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007471 | Orphan claim re-pointed Claims processor | CLM-416331 → UHC-73134-35 (Gerald Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007472 | Orphan claim re-pointed Claims processor | CLM-416597 → UHC-49912-59 (James Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007473 | Orphan claim re-pointed Claims processor | CLM-429117 → UHC-02163-23 (Brian Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007474 | Orphan claim re-pointed Claims processor | CLM-406461 → UHC-19436-23 (Marcus Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007475 | Orphan claim re-pointed Claims processor | CLM-412199 → UHC-60598-92 (Karen Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007476 | Orphan claim re-pointed Claims processor | CLM-418095 → UHC-99908-60 (Victoria Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007477 | Orphan claim re-pointed Claims processor | CLM-418298 → UHC-78599-36 (Billy Gardner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007478 | Orphan claim re-pointed Claims processor | CLM-431554 → UHC-06184-67 (Yuki Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007479 | Orphan claim re-pointed Claims processor | CLM-419318 → UHC-06404-73 (Tyler Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007480 | Orphan claim re-pointed Claims processor | CLM-418867 → UHC-82540-20 (Matthew Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007481 | Orphan claim re-pointed Claims processor | CLM-413992 → UHC-98211-28 (Anna Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007482 | Orphan claim re-pointed Claims processor | CLM-415489 → UHC-43781-63 (Alice Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007483 | Orphan claim re-pointed Claims processor | CLM-429580 → UHC-39074-82 (Katherine Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007484 | Orphan claim re-pointed Claims processor | CLM-410313 → UHC-23819-12 (Donna Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007485 | Orphan claim re-pointed Claims processor | CLM-421798 → UHC-68514-41 (Jacqueline Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007486 | Orphan claim re-pointed Claims processor | CLM-413899 → UHC-72314-39 (Mei Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007487 | Orphan claim re-pointed Claims processor | CLM-406296 → UHC-69725-87 (Becky Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007488 | Orphan claim re-pointed Claims processor | CLM-410318 → UHC-73326-27 (Angela Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007489 | Orphan claim re-pointed Claims processor | CLM-416728 → UHC-12592-10 (Ahmed Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007490 | Orphan claim re-pointed Claims processor | CLM-426621 → UHC-33731-33 (Charlotte Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007491 | Orphan claim re-pointed Claims processor | CLM-419118 → UHC-40864-53 (Gary Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007492 | Orphan claim re-pointed Claims processor | CLM-432155 → UHC-76846-41 (Kelly Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007493 | Orphan claim re-pointed Claims processor | CLM-431739 → UHC-18114-77 (Arthur Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007494 | Orphan claim re-pointed Claims processor | CLM-428839 → UHC-53711-81 (Samantha Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007495 | Orphan claim re-pointed Claims processor | CLM-423114 → UHC-29521-60 (Jonathan Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007496 | Orphan claim re-pointed Claims processor | CLM-401915 → UHC-01025-68 (Sharon Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007497 | Orphan claim re-pointed Claims processor | CLM-421259 → UHC-61130-89 (Dorothy Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007498 | Orphan claim re-pointed Claims processor | CLM-414798 → UHC-81288-01 (Billy Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007499 | Orphan claim re-pointed Claims processor | CLM-402918 → UHC-34706-33 (Roy Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007500 | Orphan claim re-pointed Claims processor | CLM-419835 → UHC-11708-31 (Albert Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007501 | Orphan claim re-pointed Claims processor | CLM-420161 → UHC-62276-24 (Abigail Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007502 | Orphan claim re-pointed Claims processor | CLM-421846 → UHC-03091-21 (Martha Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007503 | Orphan claim re-pointed Claims processor | CLM-407782 → UHC-93997-42 (Mark Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007504 | Orphan claim re-pointed Claims processor | CLM-402266 → UHC-87849-68 (Camila Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007505 | Orphan claim re-pointed Claims processor | CLM-415081 → UHC-76216-09 (James Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007506 | Orphan claim re-pointed Claims processor | CLM-426074 → UHC-88538-10 (Emily Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007507 | Orphan claim re-pointed Claims processor | CLM-414331 → UHC-83189-38 (Linda Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007508 | Orphan claim re-pointed Claims processor | CLM-402555 → UHC-52868-26 (Bruce Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007509 | Orphan claim re-pointed Claims processor | CLM-415418 → UHC-70723-03 (Keith Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007510 | Orphan claim re-pointed Claims processor | CLM-421139 → UHC-20503-28 (Arthur Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007511 | Orphan claim re-pointed Claims processor | CLM-410675 → UHC-71292-65 (Billy Gardner) |
| 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.