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-007612 | Orphan claim re-pointed Claims processor | CLM-426554 → UHC-10433-05 (Mason Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007613 | Orphan claim re-pointed Claims processor | CLM-410785 → UHC-41901-62 (Justin Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007614 | Orphan claim re-pointed Claims processor | CLM-417269 → UHC-57936-14 (Elijah Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007615 | Orphan claim re-pointed Claims processor | CLM-428510 → UHC-55442-75 (Frank Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007616 | Orphan claim re-pointed Claims processor | CLM-425314 → UHC-76683-43 (Ralph Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007617 | Orphan claim re-pointed Claims processor | CLM-405939 → UHC-49348-09 (Frances Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007618 | Orphan claim re-pointed Claims processor | CLM-419374 → UHC-74318-39 (Christine Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007619 | Orphan claim re-pointed Claims processor | CLM-429838 → UHC-19337-80 (Rachel Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007620 | Orphan claim re-pointed Claims processor | CLM-416483 → UHC-72382-09 (Arthur Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007621 | Orphan claim re-pointed Claims processor | CLM-420920 → UHC-93293-77 (Elijah Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007622 | Orphan claim re-pointed Claims processor | CLM-404929 → UHC-33686-75 (Josuha Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007623 | Orphan claim re-pointed Claims processor | CLM-421373 → UHC-79512-87 (Frances Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007624 | Orphan claim re-pointed Claims processor | CLM-402251 → UHC-28664-92 (Nancy Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007625 | Orphan claim re-pointed Claims processor | CLM-424179 → UHC-06849-83 (Joe Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007626 | Orphan claim re-pointed Claims processor | CLM-428542 → UHC-46195-40 (John Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007627 | Orphan claim re-pointed Claims processor | CLM-429811 → UHC-48838-44 (Elizabeth Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007628 | Orphan claim re-pointed Claims processor | CLM-420769 → UHC-65006-18 (Danielle Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007629 | Orphan claim re-pointed Claims processor | CLM-417129 → UHC-94499-61 (Diego Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007630 | Orphan claim re-pointed Claims processor | CLM-410481 → UHC-70616-98 (Ronald Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007631 | Orphan claim re-pointed Claims processor | CLM-404375 → UHC-14825-01 (Billy Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007632 | Orphan claim re-pointed Claims processor | CLM-419089 → UHC-03947-55 (Theresa Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007633 | Orphan claim re-pointed Claims processor | CLM-404572 → UHC-63932-33 (Susan Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007634 | Orphan claim re-pointed Claims processor | CLM-416887 → UHC-35049-87 (Jerry Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007635 | Orphan claim re-pointed Claims processor | CLM-420415 → UHC-85070-52 (Camila Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007636 | Orphan claim re-pointed Claims processor | CLM-401101 → UHC-70306-47 (Hannah Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007637 | Orphan claim re-pointed Claims processor | CLM-425022 → UHC-98289-93 (Austin Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007638 | Orphan claim re-pointed Claims processor | CLM-417826 → UHC-66935-98 (Ashley Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007639 | Orphan claim re-pointed Claims processor | CLM-431898 → UHC-38371-52 (Margaret Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007640 | Orphan claim re-pointed Claims processor | CLM-430597 → UHC-39448-14 (Nicholas Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007641 | Orphan claim re-pointed Claims processor | CLM-412897 → UHC-32595-69 (Gregory Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007642 | Orphan claim re-pointed Claims processor | CLM-430725 → UHC-21577-09 (Hiroshi Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007643 | Orphan claim re-pointed Claims processor | CLM-430496 → UHC-17406-73 (Sean Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007644 | Orphan claim re-pointed Claims processor | CLM-420658 → UHC-30457-37 (Melissa Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007645 | Orphan claim re-pointed Claims processor | CLM-403585 → UHC-23311-92 (Luis Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007646 | Orphan claim re-pointed Claims processor | CLM-409630 → UHC-66081-91 (Edward Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007647 | Orphan claim re-pointed Claims processor | CLM-404855 → UHC-25052-40 (Bobby Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007648 | Orphan claim re-pointed Claims processor | CLM-404952 → UHC-57723-01 (Logan Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007649 | Orphan claim re-pointed Claims processor | CLM-422614 → UHC-83650-20 (Justin McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007650 | Orphan claim re-pointed Claims processor | CLM-430417 → UHC-71193-02 (Valentina Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007651 | Orphan claim re-pointed Claims processor | CLM-421426 → UHC-79685-07 (Aisha Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007652 | Orphan claim re-pointed Claims processor | CLM-404033 → UHC-10810-94 (Kyle Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007653 | Orphan claim re-pointed Claims processor | CLM-404340 → UHC-95183-75 (Madison Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007654 | Orphan claim re-pointed Claims processor | CLM-414707 → UHC-65778-87 (Sophia Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007655 | Orphan claim re-pointed Claims processor | CLM-411717 → UHC-60815-26 (Alexander Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007656 | Orphan claim re-pointed Claims processor | CLM-402883 → UHC-60636-14 (Diana Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007657 | Orphan claim re-pointed Claims processor | CLM-412310 → UHC-81920-75 (Logan Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007658 | Orphan claim re-pointed Claims processor | CLM-407711 → UHC-26872-91 (Natalie Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007659 | Orphan claim re-pointed Claims processor | CLM-414674 → UHC-80386-84 (Rachel Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007660 | Orphan claim re-pointed Claims processor | CLM-415245 → UHC-89426-04 (Jeremy Vegga) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007661 | Orphan claim re-pointed Claims processor | CLM-408580 → UHC-81413-97 (Kelly 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.