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-007812 | Orphan claim re-pointed Claims processor | CLM-432387 → UHC-40021-88 (Margaret Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007813 | Orphan claim re-pointed Claims processor | CLM-422110 → UHC-09967-78 (Emily Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007814 | Orphan claim re-pointed Claims processor | CLM-418844 → UHC-84212-31 (David Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007815 | Orphan claim re-pointed Claims processor | CLM-403802 → UHC-30857-34 (Frances Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007816 | Orphan claim re-pointed Claims processor | CLM-412680 → UHC-72442-85 (Billy Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007817 | Orphan claim re-pointed Claims processor | CLM-412179 → UHC-70243-81 (Julie Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007818 | Orphan claim re-pointed Claims processor | CLM-401666 → UHC-27598-23 (Emma Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007819 | Orphan claim re-pointed Claims processor | CLM-405420 → UHC-45453-34 (Maria Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007820 | Orphan claim re-pointed Claims processor | CLM-407218 → UHC-78541-97 (Bobby Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007821 | Orphan claim re-pointed Claims processor | CLM-414631 → UHC-31118-91 (Betty Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007822 | Orphan claim re-pointed Claims processor | CLM-424075 → UHC-65631-51 (Ralph Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007823 | Orphan claim re-pointed Claims processor | CLM-422231 → UHC-49624-39 (Hiroshi Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007824 | Orphan claim re-pointed Claims processor | CLM-409578 → UHC-88223-20 (Luis Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007825 | Orphan claim re-pointed Claims processor | CLM-408487 → UHC-60615-04 (Austin Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007826 | Orphan claim re-pointed Claims processor | CLM-410817 → UHC-19980-14 (Stephen Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007827 | Orphan claim re-pointed Claims processor | CLM-408412 → UHC-53467-07 (Bobby Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007828 | Orphan claim re-pointed Claims processor | CLM-424512 → UHC-62449-29 (Justin Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007829 | Orphan claim re-pointed Claims processor | CLM-430537 → UHC-86464-10 (Alexis Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007830 | Orphan claim re-pointed Claims processor | CLM-400294 → UHC-16705-36 (Valentina Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007831 | Orphan claim re-pointed Claims processor | CLM-429273 → UHC-52708-61 (Madison Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007832 | Orphan claim re-pointed Claims processor | CLM-408982 → UHC-84014-04 (Joan Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007833 | Orphan claim re-pointed Claims processor | CLM-427841 → UHC-62019-85 (Eirc Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007834 | Orphan claim re-pointed Claims processor | CLM-426712 → UHC-56407-99 (Teresa Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007835 | Orphan claim re-pointed Claims processor | CLM-417450 → UHC-03925-28 (Kenneth Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007836 | Orphan claim re-pointed Claims processor | CLM-402782 → UHC-58954-87 (Wei Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007837 | Orphan claim re-pointed Claims processor | CLM-403640 → UHC-11908-79 (Dorothy Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007838 | Orphan claim re-pointed Claims processor | CLM-412441 → UHC-68781-22 (Timothy Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007839 | Orphan claim re-pointed Claims processor | CLM-401791 → UHC-38852-43 (Walter Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007840 | Orphan claim re-pointed Claims processor | CLM-401306 → UHC-76653-03 (Kelly James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007841 | Orphan claim re-pointed Claims processor | CLM-418061 → UHC-48631-14 (Dorothy Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007842 | Orphan claim re-pointed Claims processor | CLM-422279 → UHC-25874-35 (Judith Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007843 | Orphan claim re-pointed Claims processor | CLM-428765 → UHC-27150-81 (Elizabeth Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007844 | Orphan claim re-pointed Claims processor | CLM-413675 → UHC-45287-35 (Carol Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007845 | Orphan claim re-pointed Claims processor | CLM-419090 → UHC-03947-55 (Theresa Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007846 | Orphan claim re-pointed Claims processor | CLM-416404 → UHC-36430-99 (Danielle Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007847 | Orphan claim re-pointed Claims processor | CLM-404376 → UHC-61358-21 (Danielle Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007848 | Orphan claim re-pointed Claims processor | CLM-428412 → UHC-47454-98 (William Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007849 | Orphan claim re-pointed Claims processor | CLM-404238 → UHC-57767-40 (Evelyn Gomez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007850 | Orphan claim re-pointed Claims processor | CLM-432295 → UHC-96578-99 (Aisha Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007851 | Orphan claim re-pointed Claims processor | CLM-403652 → UHC-47113-40 (Christian Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007852 | Orphan claim re-pointed Claims processor | CLM-419571 → UHC-39684-13 (Lisa Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007853 | Orphan claim re-pointed Claims processor | CLM-425082 → UHC-20983-31 (Peter Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007854 | Orphan claim re-pointed Claims processor | CLM-429268 → UHC-74857-31 (Kyle Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007855 | Orphan claim re-pointed Claims processor | CLM-402543 → UHC-03463-23 (Alexis Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007856 | Orphan claim re-pointed Claims processor | CLM-409933 → UHC-42815-90 (Jeffrey Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007857 | Orphan claim re-pointed Claims processor | CLM-415462 → UHC-35281-32 (Frances Roes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007858 | Orphan claim re-pointed Claims processor | CLM-407414 → UHC-50574-79 (Diego Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007859 | Orphan claim re-pointed Claims processor | CLM-400453 → UHC-49635-09 (Amanda Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007860 | Orphan claim re-pointed Claims processor | CLM-430634 → UHC-65543-73 (Alexis Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007861 | Orphan claim re-pointed Claims processor | CLM-403284 → UHC-52805-66 (Judith Gilbert) |
| 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.