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-002740 | Orphan claim re-pointed Claims processor | CLM-411257 → UHC-34912-78 (Jessica Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002741 | Orphan claim re-pointed Claims processor | CLM-418147 → UHC-72529-98 (Vincent Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002742 | Orphan claim re-pointed Claims processor | CLM-412184 → UHC-00823-45 (Kathryn Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002743 | Orphan claim re-pointed Claims processor | CLM-417916 → UHC-78083-57 (Judith West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002744 | Orphan claim re-pointed Claims processor | CLM-405477 → UHC-12782-69 (Watson Steven) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002745 | Orphan claim re-pointed Claims processor | CLM-400217 → UHC-17817-28 (Harold Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002746 | Orphan claim re-pointed Claims processor | CLM-410227 → UHC-56472-37 (Lori Coooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002747 | Orphan claim re-pointed Claims processor | CLM-406085 → UHC-37995-02 (Santiago Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002748 | Orphan claim re-pointed Claims processor | CLM-409191 → UHC-85772-60 (Jerry Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002749 | Orphan claim re-pointed Claims processor | CLM-418685 → UHC-97712-18 (Noah Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002750 | Orphan claim re-pointed Claims processor | CLM-428646 → UHC-43545-99 (Madison Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002751 | Orphan claim re-pointed Claims processor | CLM-405306 → UHC-89211-17 (Dnise Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002752 | Orphan claim re-pointed Claims processor | CLM-417263 → UHC-30181-71 (Adam Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002753 | Orphan claim re-pointed Claims processor | CLM-413608 → UHC-19719-99 (Lucia Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002754 | Orphan claim re-pointed Claims processor | CLM-432537 → UHC-00910-81 (Doris McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002755 | Orphan claim re-pointed Claims processor | CLM-420757 → UHC-29811-40 (Ken Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002756 | Orphan claim re-pointed Claims processor | CLM-401682 → UHC-35149-69 (Abigail Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002757 | Orphan claim re-pointed Claims processor | CLM-414970 → UHC-58152-86 (Barbara Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002758 | Orphan claim re-pointed Claims processor | CLM-400353 → UHC-40216-61 (Elizabeth Elizabeth) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002759 | Orphan claim re-pointed Claims processor | CLM-419161 → UHC-32991-98 (Benjamin Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002760 | Orphan claim re-pointed Claims processor | CLM-425440 → UHC-25028-43 (Donald Lene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002761 | Orphan claim re-pointed Claims processor | CLM-429052 → UHC-36756-03 (William Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002762 | Orphan claim re-pointed Claims processor | CLM-408867 → UHC-03470-58 (George Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002763 | Orphan claim re-pointed Claims processor | CLM-419274 → UHC-51195-87 (Kelly Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002764 | Orphan claim re-pointed Claims processor | CLM-428978 → UHC-20430-89 (Julia Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002765 | Orphan claim re-pointed Claims processor | CLM-402952 → UHC-52045-15 (Linda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002766 | Orphan claim re-pointed Claims processor | CLM-420603 → UHC-33706-77 (Bryan Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002767 | Orphan claim re-pointed Claims processor | CLM-421601 → UHC-05399-64 (Shirley Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002768 | Orphan claim re-pointed Claims processor | CLM-407019 → UHC-48679-36 (David Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002769 | Orphan claim re-pointed Claims processor | CLM-425431 → UHC-14829-62 (Larry Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002770 | Orphan claim re-pointed Claims processor | CLM-421484 → UHC-06965-04 (Noah Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002771 | Orphan claim re-pointed Claims processor | CLM-422783 → UHC-17335-35 (Eric Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002772 | Orphan claim re-pointed Claims processor | CLM-424102 → UHC-36356-27 (Edward George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002773 | Orphan claim re-pointed Claims processor | CLM-415152 → UHC-65736-97 (Cynthia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002774 | Orphan claim re-pointed Claims processor | CLM-427615 → UHC-70116-01 (Matthew Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002775 | Orphan claim re-pointed Claims processor | CLM-427100 → UHC-63226-44 (Timothy Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002776 | Orphan claim re-pointed Claims processor | CLM-417083 → UHC-05458-06 (Theresa Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002777 | Orphan claim re-pointed Claims processor | CLM-426786 → UHC-75200-93 (Angela Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002778 | Orphan claim re-pointed Claims processor | CLM-407263 → UHC-05853-23 (Thomas Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002779 | Orphan claim re-pointed Claims processor | CLM-426182 → UHC-01358-75 (Kevin Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002780 | Orphan claim re-pointed Claims processor | CLM-432126 → UHC-30484-31 (Raymond Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002781 | Orphan claim re-pointed Claims processor | CLM-423972 → UHC-90465-53 (Isabella Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002782 | Orphan claim re-pointed Claims processor | CLM-430210 → UHC-63930-87 (Alan Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002783 | Orphan claim re-pointed Claims processor | CLM-402562 → UHC-84832-60 (Melissa Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002784 | Orphan claim re-pointed Claims processor | CLM-428295 → UHC-94402-84 (Anna Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002785 | Orphan claim re-pointed Claims processor | CLM-429082 → UHC-44841-77 (Lawrence Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002786 | Orphan claim re-pointed Claims processor | CLM-423108 → UHC-04176-72 (Raymond Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002787 | Orphan claim re-pointed Claims processor | CLM-405530 → UHC-66614-26 (Denise Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002788 | Orphan claim re-pointed Claims processor | CLM-422681 → UHC-21693-90 (Dylan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002789 | Orphan claim re-pointed Claims processor | CLM-407916 → UHC-74491-09 (Gabriel Castro) |
| 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.