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-007762 | Orphan claim re-pointed Claims processor | CLM-404927 → UHC-99163-01 (Vincent Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007763 | Orphan claim re-pointed Claims processor | CLM-415650 → UHC-45989-53 (Charles Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007764 | Orphan claim re-pointed Claims processor | CLM-412571 → UHC-54449-78 (Noah Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007765 | Orphan claim re-pointed Claims processor | CLM-429855 → UHC-22640-29 (Amanda Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007766 | Orphan claim re-pointed Claims processor | CLM-429628 → UHC-50638-68 (Christopher Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007767 | Orphan claim re-pointed Claims processor | CLM-416314 → UHC-16929-82 (Lucia Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007768 | Orphan claim re-pointed Claims processor | CLM-402088 → UHC-04491-04 (Omar Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007769 | Orphan claim re-pointed Claims processor | CLM-426707 → UHC-49414-59 (Gregory Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007770 | Orphan claim re-pointed Claims processor | CLM-419898 → UHC-83000-99 (Amy Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007771 | Orphan claim re-pointed Claims processor | CLM-404814 → UHC-50386-34 (Bobby Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007772 | Orphan claim re-pointed Claims processor | CLM-402681 → UHC-46973-89 (Kenneth Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007773 | Orphan claim re-pointed Claims processor | CLM-414989 → UHC-96876-11 (Lori Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007774 | Orphan claim re-pointed Claims processor | CLM-406571 → UHC-69881-24 (Jean Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007775 | Orphan claim re-pointed Claims processor | CLM-413058 → UHC-07773-71 (Danielle Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007776 | Orphan claim re-pointed Claims processor | CLM-430977 → UHC-59549-90 (Stephanie Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007777 | Orphan claim re-pointed Claims processor | CLM-426626 → UHC-06372-33 (Jennifer Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007778 | Orphan claim re-pointed Claims processor | CLM-419350 → UHC-54757-66 (Marilyn Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007779 | Orphan claim re-pointed Claims processor | CLM-408021 → UHC-21036-35 (Carlos Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007780 | Orphan claim re-pointed Claims processor | CLM-403062 → UHC-07902-98 (Julie Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007781 | Orphan claim re-pointed Claims processor | CLM-429812 → UHC-48838-44 (Elizabeth Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007782 | Orphan claim re-pointed Claims processor | CLM-424098 → UHC-56905-68 (Russell Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007783 | Orphan claim re-pointed Claims processor | CLM-400288 → UHC-84952-58 (Ryan Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007784 | Orphan claim re-pointed Claims processor | CLM-418399 → UHC-90566-12 (Christian Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007785 | Orphan claim re-pointed Claims processor | CLM-409916 → UHC-41645-14 (Kathleen Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007786 | Orphan claim re-pointed Claims processor | CLM-424578 → UHC-37864-18 (Austin Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007787 | Orphan claim re-pointed Claims processor | CLM-413081 → UHC-71280-23 (Joyce Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007788 | Orphan claim re-pointed Claims processor | CLM-403974 → UHC-20168-56 (Hannah Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007789 | Orphan claim re-pointed Claims processor | CLM-427648 → UHC-87953-54 (Margaret Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007790 | Orphan claim re-pointed Claims processor | CLM-429620 → UHC-66748-29 (Robert Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007791 | Orphan claim re-pointed Claims processor | CLM-401492 → UHC-06635-80 (Bruce Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007792 | Orphan claim re-pointed Claims processor | CLM-408068 → UHC-79113-04 (Mary Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007793 | Orphan claim re-pointed Claims processor | CLM-408995 → UHC-49588-49 (Alan Buke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007794 | Orphan claim re-pointed Claims processor | CLM-430160 → UHC-26988-86 (Yuki Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007795 | Orphan claim re-pointed Claims processor | CLM-429780 → UHC-69402-86 (Stephen Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007796 | Orphan claim re-pointed Claims processor | CLM-431546 → UHC-60838-89 (Christian Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007797 | Orphan claim re-pointed Claims processor | CLM-425882 → UHC-85627-10 (Robert Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007798 | Orphan claim re-pointed Claims processor | CLM-400291 → UHC-30695-21 (Brian Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007799 | Orphan claim re-pointed Claims processor | CLM-419339 → UHC-85345-13 (Fatima Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007800 | Orphan claim re-pointed Claims processor | CLM-409166 → UHC-80089-58 (Juan Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007801 | Orphan claim re-pointed Claims processor | CLM-407010 → UHC-36481-22 (Ethan Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007802 | Orphan claim re-pointed Claims processor | CLM-416787 → UHC-34296-72 (George Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007803 | Orphan claim re-pointed Claims processor | CLM-402360 → UHC-31543-99 (Wayne McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007804 | Orphan claim re-pointed Claims processor | CLM-406404 → UHC-39935-89 (Marcus Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007805 | Orphan claim re-pointed Claims processor | CLM-415855 → UHC-20229-05 (Debra Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007806 | Orphan claim re-pointed Claims processor | CLM-404142 → UHC-00259-16 (Betty Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007807 | Orphan claim re-pointed Claims processor | CLM-420188 → UHC-80890-25 (George Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007808 | Orphan claim re-pointed Claims processor | CLM-400705 → UHC-36383-41 (Brian Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007809 | Orphan claim re-pointed Claims processor | CLM-406710 → UHC-37203-81 (Marianna Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007810 | Orphan claim re-pointed Claims processor | CLM-411533 → UHC-11070-99 (Logan Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007811 | Orphan claim re-pointed Claims processor | CLM-426823 → UHC-66444-97 (Jerry Lane) |
| 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.