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-007662 | Orphan claim re-pointed Claims processor | CLM-418872 → UHC-79380-69 (Joseph Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007663 | Orphan claim re-pointed Claims processor | CLM-419313 → UHC-83325-61 (Virginia Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007664 | Orphan claim re-pointed Claims processor | CLM-415761 → UHC-91168-07 (Emily Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007665 | Orphan claim re-pointed Claims processor | CLM-431523 → UHC-96267-36 (Christina Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007666 | Orphan claim re-pointed Claims processor | CLM-405177 → UHC-83774-86 (Mariana Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007667 | Orphan claim re-pointed Claims processor | CLM-419439 → UHC-90187-32 (Adam Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007668 | Orphan claim re-pointed Claims processor | CLM-413206 → UHC-96439-17 (Danielle Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007669 | Orphan claim re-pointed Claims processor | CLM-421706 → UHC-15406-67 (Aisha Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007670 | Orphan claim re-pointed Claims processor | CLM-405087 → UHC-66627-67 (Janice Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007671 | Orphan claim re-pointed Claims processor | CLM-419028 → UHC-54434-24 (Natalie Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007672 | Orphan claim re-pointed Claims processor | CLM-416698 → UHC-75227-62 (Luis Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007673 | Orphan claim re-pointed Claims processor | CLM-424154 → UHC-78452-70 (Joshua Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007674 | Orphan claim re-pointed Claims processor | CLM-418831 → UHC-95582-35 (Jose Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007675 | Orphan claim re-pointed Claims processor | CLM-414116 → UHC-18539-67 (Paul Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007676 | Orphan claim re-pointed Claims processor | CLM-431735 → UHC-18114-77 (Arthur Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007677 | Orphan claim re-pointed Claims processor | CLM-423790 → UHC-79179-52 (Dennis Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007678 | Orphan claim re-pointed Claims processor | CLM-426817 → UHC-17778-93 (Stephanie Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007679 | Orphan claim re-pointed Claims processor | CLM-417070 → UHC-73875-97 (Sara Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007680 | Orphan claim re-pointed Claims processor | CLM-411490 → UHC-99380-89 (Lucia Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007681 | Orphan claim re-pointed Claims processor | CLM-425432 → UHC-14829-62 (Larry Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007682 | Orphan claim re-pointed Claims processor | CLM-429166 → UHC-70952-79 (Nathan Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007683 | Orphan claim re-pointed Claims processor | CLM-403913 → UHC-93972-21 (Jessiac Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007684 | Orphan claim re-pointed Claims processor | CLM-429707 → UHC-18032-11 (Stephen Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007685 | Orphan claim re-pointed Claims processor | CLM-422315 → UHC-46337-12 (Lisa Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007686 | Orphan claim re-pointed Claims processor | CLM-431720 → UHC-22895-17 (Maria Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007687 | Orphan claim re-pointed Claims processor | CLM-415206 → UHC-86415-53 (Betty Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007688 | Orphan claim re-pointed Claims processor | CLM-414912 → UHC-89766-39 (Dennis Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007689 | Orphan claim re-pointed Claims processor | CLM-425110 → UHC-46808-74 (Teresa Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007690 | Orphan claim re-pointed Claims processor | CLM-422735 → UHC-51537-03 (Roger Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007691 | Orphan claim re-pointed Claims processor | CLM-431557 → UHC-06184-67 (Yuki Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007692 | Orphan claim re-pointed Claims processor | CLM-427842 → UHC-62350-39 (Jack Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007693 | Orphan claim re-pointed Claims processor | CLM-407758 → UHC-30615-60 (Daniel Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007694 | Orphan claim re-pointed Claims processor | CLM-400906 → UHC-75549-63 (Adam Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007695 | Orphan claim re-pointed Claims processor | CLM-421406 → UHC-26837-69 (Aisha Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007696 | Orphan claim re-pointed Claims processor | CLM-403887 → UHC-15892-86 (Gabriel Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007697 | Orphan claim re-pointed Claims processor | CLM-426838 → UHC-56314-20 (Carolyn Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007698 | Orphan claim re-pointed Claims processor | CLM-417897 → UHC-65661-98 (Brian Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007699 | Orphan claim re-pointed Claims processor | CLM-403458 → UHC-07604-11 (Samuel Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007700 | Orphan claim re-pointed Claims processor | CLM-410855 → UHC-47698-99 (Katherine Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007701 | Orphan claim re-pointed Claims processor | CLM-409408 → UHC-98890-36 (Mason Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007702 | Orphan claim re-pointed Claims processor | CLM-404958 → UHC-22808-33 (Raachel Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007703 | Orphan claim re-pointed Claims processor | CLM-431096 → UHC-84529-42 (Karen Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007704 | Orphan claim re-pointed Claims processor | CLM-430440 → UHC-60914-75 (Gerald Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007705 | Orphan claim re-pointed Claims processor | CLM-404226 → UHC-92454-63 (Marcus Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007706 | Orphan claim re-pointed Claims processor | CLM-419743 → UHC-10969-44 (Christina Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007707 | Orphan claim re-pointed Claims processor | CLM-409462 → UHC-02296-66 (Jerry Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007708 | Orphan claim re-pointed Claims processor | CLM-431331 → UHC-37861-98 (Logan Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007709 | Orphan claim re-pointed Claims processor | CLM-409495 → UHC-18051-11 (Justin Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007710 | Orphan claim re-pointed Claims processor | CLM-426865 → UHC-57023-24 (Brandon Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007711 | Orphan claim re-pointed Claims processor | CLM-402807 → UHC-29388-20 (Joyce Guerrero) |
| 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.