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-007712 | Orphan claim re-pointed Claims processor | CLM-414316 → UHC-59431-11 (Carolyn Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007713 | Orphan claim re-pointed Claims processor | CLM-402294 → UHC-84577-80 (Julie Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007714 | Orphan claim re-pointed Claims processor | CLM-431945 → UHC-47195-70 (Diane Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007715 | Orphan claim re-pointed Claims processor | CLM-412219 → UHC-67757-69 (Ahmed Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007716 | Orphan claim re-pointed Claims processor | CLM-406800 → UHC-72508-09 (Teresa Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007717 | Orphan claim re-pointed Claims processor | CLM-422993 → UHC-79259-25 (Betty Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007718 | Orphan claim re-pointed Claims processor | CLM-429255 → UHC-86504-87 (Mei Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007719 | Orphan claim re-pointed Claims processor | CLM-427799 → UHC-31711-68 (Jason Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007720 | Orphan claim re-pointed Claims processor | CLM-405564 → UHC-76339-06 (Jack Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007721 | Orphan claim re-pointed Claims processor | CLM-400697 → UHC-94092-96 (Yuki Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007722 | Orphan claim re-pointed Claims processor | CLM-409952 → UHC-55063-31 (Douglas Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007723 | Orphan claim re-pointed Claims processor | CLM-405263 → UHC-17023-89 (Judith Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007724 | Orphan claim re-pointed Claims processor | CLM-420056 → UHC-71570-03 (Robert Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007725 | Orphan claim re-pointed Claims processor | CLM-411082 → UHC-73884-55 (Gabriel Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007726 | Orphan claim re-pointed Claims processor | CLM-426799 → UHC-13697-19 (Scott Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007727 | Orphan claim re-pointed Claims processor | CLM-410055 → UHC-68288-17 (Emma Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007728 | Orphan claim re-pointed Claims processor | CLM-423792 → UHC-42367-19 (Saamntha Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007729 | Orphan claim re-pointed Claims processor | CLM-412914 → UHC-78353-92 (Margaret Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007730 | Orphan claim re-pointed Claims processor | CLM-415671 → UHC-43243-09 (Karen Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007731 | Orphan claim re-pointed Claims processor | CLM-411748 → UHC-80429-86 (Seaan Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007732 | Orphan claim re-pointed Claims processor | CLM-419630 → UHC-44088-21 (Diego Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007733 | Orphan claim re-pointed Claims processor | CLM-422285 → UHC-51601-85 (Maria Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007734 | Orphan claim re-pointed Claims processor | CLM-425568 → UHC-72694-61 (Peter Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007735 | Orphan claim re-pointed Claims processor | CLM-419298 → UHC-12076-16 (Isabella Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007736 | Orphan claim re-pointed Claims processor | CLM-425776 → UHC-19163-11 (Karen Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007737 | Orphan claim re-pointed Claims processor | CLM-408916 → UHC-61611-95 (Peter Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007738 | Orphan claim re-pointed Claims processor | CLM-425968 → UHC-84938-93 (Sophia Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007739 | Orphan claim re-pointed Claims processor | CLM-424563 → UHC-27034-47 (Bruce Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007740 | Orphan claim re-pointed Claims processor | CLM-407031 → UHC-53622-56 (Olivia Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007741 | Orphan claim re-pointed Claims processor | CLM-418687 → UHC-41801-41 (Samuel Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007742 | Orphan claim re-pointed Claims processor | CLM-406934 → UHC-49832-15 (Lisa Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007743 | Orphan claim re-pointed Claims processor | CLM-418289 → UHC-39736-97 (Christine Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007744 | Orphan claim re-pointed Claims processor | CLM-422267 → UHC-77345-52 (Christina Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007745 | Orphan claim re-pointed Claims processor | CLM-418922 → UHC-95565-83 (Mary Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007746 | Orphan claim re-pointed Claims processor | CLM-400077 → UHC-30103-89 (Helen Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007747 | Orphan claim re-pointed Claims processor | CLM-428389 → UHC-22171-96 (Frank Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007748 | Orphan claim re-pointed Claims processor | CLM-417562 → UHC-29409-54 (Bobby Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007749 | Orphan claim re-pointed Claims processor | CLM-408508 → UHC-84176-83 (Brenda Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007750 | Orphan claim re-pointed Claims processor | CLM-406139 → UHC-20478-93 (Jacob Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007751 | Orphan claim re-pointed Claims processor | CLM-427222 → UHC-68801-10 (Teresa Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007752 | Orphan claim re-pointed Claims processor | CLM-413776 → UHC-19036-31 (Frank Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007753 | Orphan claim re-pointed Claims processor | CLM-432767 → UHC-45303-32 (Doris Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007754 | Orphan claim re-pointed Claims processor | CLM-415169 → UHC-57734-49 (Isabella Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007755 | Orphan claim re-pointed Claims processor | CLM-417343 → UHC-57685-41 (Kimberly Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007756 | Orphan claim re-pointed Claims processor | CLM-419922 → UHC-47161-46 (Rlph Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007757 | Orphan claim re-pointed Claims processor | CLM-422031 → UHC-88438-07 (Julie Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007758 | Orphan claim re-pointed Claims processor | CLM-421102 → UHC-83726-54 (Jeremy Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007759 | Orphan claim re-pointed Claims processor | CLM-415917 → UHC-84155-80 (Karen Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007760 | Orphan claim re-pointed Claims processor | CLM-429630 → UHC-25427-90 (Amber Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007761 | Orphan claim re-pointed Claims processor | CLM-429949 → UHC-28727-85 (Frances Hansen) |
| 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.