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-007562 | Orphan claim re-pointed Claims processor | CLM-412989 → UHC-29703-02 (Jeremy Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007563 | Orphan claim re-pointed Claims processor | CLM-406640 → UHC-62854-39 (Harold Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007564 | Orphan claim re-pointed Claims processor | CLM-414971 → UHC-01437-64 (Randy Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007565 | Orphan claim re-pointed Claims processor | CLM-423211 → UHC-60287-08 (Elijah Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007566 | Orphan claim re-pointed Claims processor | CLM-403536 → UHC-08056-64 (Joyce Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007567 | Orphan claim re-pointed Claims processor | CLM-408161 → UHC-40423-93 (Vincent Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007568 | Orphan claim re-pointed Claims processor | CLM-414801 → UHC-97777-54 (Martha Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007569 | Orphan claim re-pointed Claims processor | CLM-423141 → UHC-21870-52 (Virginia Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007570 | Orphan claim re-pointed Claims processor | CLM-402273 → UHC-32066-26 (Angela Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007571 | Orphan claim re-pointed Claims processor | CLM-404384 → UHC-28737-10 (Charlotte Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007572 | Orphan claim re-pointed Claims processor | CLM-404802 → UHC-90669-86 (Kyle Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007573 | Orphan claim re-pointed Claims processor | CLM-401978 → UHC-13395-79 (Tyler Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007574 | Orphan claim re-pointed Claims processor | CLM-414169 → UHC-85864-70 (Angela Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007575 | Orphan claim re-pointed Claims processor | CLM-414551 → UHC-58214-02 (Gloria Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007576 | Orphan claim re-pointed Claims processor | CLM-429978 → UHC-33868-33 (Jacob Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007577 | Orphan claim re-pointed Claims processor | CLM-430627 → UHC-76455-82 (Edward Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007578 | Orphan claim re-pointed Claims processor | CLM-410046 → UHC-92857-60 (Sean Sean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007579 | Orphan claim re-pointed Claims processor | CLM-428582 → UHC-92566-61 (Melissa Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007580 | Orphan claim re-pointed Claims processor | CLM-413814 → UHC-52657-16 (Sara Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007581 | Orphan claim re-pointed Claims processor | CLM-400701 → UHC-01302-07 (Cheryl Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007582 | Orphan claim re-pointed Claims processor | CLM-418788 → UHC-67519-46 (Larry Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007583 | Orphan claim re-pointed Claims processor | CLM-411638 → UHC-84222-34 (Abigail Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007584 | Orphan claim re-pointed Claims processor | CLM-427973 → UHC-05006-39 (Christopher Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007585 | Orphan claim re-pointed Claims processor | CLM-402769 → UHC-82117-14 (Gloria Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007586 | Orphan claim re-pointed Claims processor | CLM-409152 → UHC-31735-63 (Nicole Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007587 | Orphan claim re-pointed Claims processor | CLM-432715 → UHC-06936-55 (Randy Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007588 | Orphan claim re-pointed Claims processor | CLM-407948 → UHC-33684-39 (Judy Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007589 | Orphan claim re-pointed Claims processor | CLM-416355 → UHC-32256-98 (Bruce Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007590 | Orphan claim re-pointed Claims processor | CLM-414326 → UHC-85826-69 (Luis Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007591 | Orphan claim re-pointed Claims processor | CLM-427971 → UHC-89444-27 (Hannah Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007592 | Orphan claim re-pointed Claims processor | CLM-419692 → UHC-17184-54 (Jeremy Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007593 | Orphan claim re-pointed Claims processor | CLM-410030 → UHC-19618-72 (William Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007594 | Orphan claim re-pointed Claims processor | CLM-410066 → UHC-20345-09 (Martha Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007595 | Orphan claim re-pointed Claims processor | CLM-421760 → UHC-97057-97 (Isabella Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007596 | Orphan claim re-pointed Claims processor | CLM-412950 → UHC-69693-06 (David Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007597 | Orphan claim re-pointed Claims processor | CLM-416980 → UHC-19530-96 (Sarah Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007598 | Orphan claim re-pointed Claims processor | CLM-423632 → UHC-00515-59 (Ryan Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007599 | Orphan claim re-pointed Claims processor | CLM-409312 → UHC-16964-87 (Douglas Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007600 | Orphan claim re-pointed Claims processor | CLM-415220 → UHC-04124-95 (Lawrence Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007601 | Orphan claim re-pointed Claims processor | CLM-404906 → UHC-57453-80 (Nancy Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007602 | Orphan claim re-pointed Claims processor | CLM-424333 → UHC-81293-58 (Sofia Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007603 | Orphan claim re-pointed Claims processor | CLM-428940 → UHC-10473-09 (Victoria Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007604 | Orphan claim re-pointed Claims processor | CLM-406612 → UHC-87595-03 (Joseph Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007605 | Orphan claim re-pointed Claims processor | CLM-407377 → UHC-56836-11 (Joe Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007606 | Orphan claim re-pointed Claims processor | CLM-405459 → UHC-61727-63 (Denise Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007607 | Orphan claim re-pointed Claims processor | CLM-429127 → UHC-76656-69 (Lauren Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007608 | Orphan claim re-pointed Claims processor | CLM-404389 → UHC-03319-04 (Deniise Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007609 | Orphan claim re-pointed Claims processor | CLM-426470 → UHC-81117-27 (Bobby Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007610 | Orphan claim re-pointed Claims processor | CLM-410869 → UHC-57895-27 (Frank Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007611 | Orphan claim re-pointed Claims processor | CLM-426654 → UHC-70640-04 (Joseph Flores) |
| 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.