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-007512 | Orphan claim re-pointed Claims processor | CLM-420990 → UHC-72496-83 (Heather Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007513 | Orphan claim re-pointed Claims processor | CLM-418561 → UHC-91227-85 (Stephen Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007514 | Orphan claim re-pointed Claims processor | CLM-420457 → UHC-71644-84 (Samantha Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007515 | Orphan claim re-pointed Claims processor | CLM-406789 → UHC-12444-24 (Diana James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007516 | Orphan claim re-pointed Claims processor | CLM-430887 → UHC-30278-64 (George Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007517 | Orphan claim re-pointed Claims processor | CLM-428414 → UHC-65934-13 (Nicholas Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007518 | Orphan claim re-pointed Claims processor | CLM-403378 → UHC-90646-48 (Roy Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007519 | Orphan claim re-pointed Claims processor | CLM-422765 → UHC-49598-70 (Andrea Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007520 | Orphan claim re-pointed Claims processor | CLM-432553 → UHC-54469-23 (Camila Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007521 | Orphan claim re-pointed Claims processor | CLM-421172 → UHC-61674-63 (Joyce Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007522 | Orphan claim re-pointed Claims processor | CLM-431063 → UHC-74905-30 (Carolyn Sotto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007523 | Orphan claim re-pointed Claims processor | CLM-422401 → UHC-06772-04 (Sharon Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007524 | Orphan claim re-pointed Claims processor | CLM-430782 → UHC-48702-23 (Catherine Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007525 | Orphan claim re-pointed Claims processor | CLM-404155 → UHC-47212-39 (Olivia Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007526 | Orphan claim re-pointed Claims processor | CLM-420321 → UHC-80809-16 (Isabella Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007527 | Orphan claim re-pointed Claims processor | CLM-401465 → UHC-10719-99 (Barbara Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007528 | Orphan claim re-pointed Claims processor | CLM-425036 → UHC-89357-17 (Brittany Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007529 | Orphan claim re-pointed Claims processor | CLM-407395 → UHC-82109-72 (Madison Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007530 | Orphan claim re-pointed Claims processor | CLM-426774 → UHC-33663-44 (Bradley Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007531 | Orphan claim re-pointed Claims processor | CLM-408460 → UHC-01984-24 (Brenda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007532 | Orphan claim re-pointed Claims processor | CLM-420892 → UHC-34115-12 (Benjamin Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007533 | Orphan claim re-pointed Claims processor | CLM-431795 → UHC-48995-75 (Amber Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007534 | Orphan claim re-pointed Claims processor | CLM-421896 → UHC-62313-89 (Ethan Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007535 | Orphan claim re-pointed Claims processor | CLM-424810 → UHC-11944-53 (Charles Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007536 | Orphan claim re-pointed Claims processor | CLM-417328 → UHC-18243-61 (Michael Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007537 | Orphan claim re-pointed Claims processor | CLM-426339 → UHC-90493-22 (Eugene Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007538 | Orphan claim re-pointed Claims processor | CLM-410042 → UHC-00360-38 (Sharon Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007539 | Orphan claim re-pointed Claims processor | CLM-420953 → UHC-28875-07 (Hiroshi Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007540 | Orphan claim re-pointed Claims processor | CLM-403551 → UHC-39760-46 (Carolyn Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007541 | Orphan claim re-pointed Claims processor | CLM-426827 → UHC-23152-20 (Joe Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007542 | Orphan claim re-pointed Claims processor | CLM-426825 → UHC-44713-38 (Priya Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007543 | Orphan claim re-pointed Claims processor | CLM-405749 → UHC-76564-15 (Rebcca Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007544 | Orphan claim re-pointed Claims processor | CLM-429113 → UHC-50353-26 (Santiago Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007545 | Orphan claim re-pointed Claims processor | CLM-416026 → UHC-85647-30 (Doris Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007546 | Orphan claim re-pointed Claims processor | CLM-425141 → UHC-39394-36 (Priya Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007547 | Orphan claim re-pointed Claims processor | CLM-418740 → UHC-04699-13 (Dylan Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007548 | Orphan claim re-pointed Claims processor | CLM-431933 → UHC-33190-68 (Austin Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007549 | Orphan claim re-pointed Claims processor | CLM-406418 → UHC-61064-10 (Heather Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007550 | Orphan claim re-pointed Claims processor | CLM-411910 → UHC-80446-31 (Roy Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007551 | Orphan claim re-pointed Claims processor | CLM-404585 → UHC-78762-82 (Maria Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007552 | Orphan claim re-pointed Claims processor | CLM-405494 → UHC-41558-85 (Lori Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007553 | Orphan claim re-pointed Claims processor | CLM-425132 → UHC-46627-03 (Nicole Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007554 | Orphan claim re-pointed Claims processor | CLM-404248 → UHC-14129-58 (Juhn Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007555 | Orphan claim re-pointed Claims processor | CLM-414288 → UHC-59874-28 (Raymond Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007556 | Orphan claim re-pointed Claims processor | CLM-430884 → UHC-35290-99 (Joshua Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007557 | Orphan claim re-pointed Claims processor | CLM-417685 → UHC-62167-58 (Amy Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007558 | Orphan claim re-pointed Claims processor | CLM-432643 → UHC-47694-32 (Hiroshi Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007559 | Orphan claim re-pointed Claims processor | CLM-427982 → UHC-06532-92 (Abigail Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007560 | Orphan claim re-pointed Claims processor | CLM-419091 → UHC-80215-67 (Frances Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007561 | Orphan claim re-pointed Claims processor | CLM-410639 → UHC-76324-61 (Eugene Peterson) |
| 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.