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-007862 | Orphan claim re-pointed Claims processor | CLM-428533 → UHC-09404-57 (Richard Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007863 | Orphan claim re-pointed Claims processor | CLM-410427 → UHC-83700-12 (Jerry Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007864 | Orphan claim re-pointed Claims processor | CLM-415280 → UHC-85448-95 (Frank Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007865 | Orphan claim re-pointed Claims processor | CLM-430362 → UHC-76562-94 (Janet Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007866 | Orphan claim re-pointed Claims processor | CLM-401803 → UHC-51799-64 (Kayla Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007867 | Orphan claim re-pointed Claims processor | CLM-406101 → UHC-53291-78 (Bobby Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007868 | Orphan claim re-pointed Claims processor | CLM-405665 → UHC-41947-43 (Jacqueline Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007869 | Orphan claim re-pointed Claims processor | CLM-413396 → UHC-47275-39 (Keith Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007870 | Orphan claim re-pointed Claims processor | CLM-404338 → UHC-45612-99 (Jeremy Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007871 | Orphan claim re-pointed Claims processor | CLM-421409 → UHC-26837-69 (Aisha Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007872 | Orphan claim re-pointed Claims processor | CLM-423007 → UHC-12628-50 (John Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007873 | Orphan claim re-pointed Claims processor | CLM-430243 → UHC-44029-86 (Wayne Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007874 | Orphan claim re-pointed Claims processor | CLM-428376 → UHC-97769-98 (David Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007875 | Orphan claim re-pointed Claims processor | CLM-417856 → UHC-90448-89 (Joan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007876 | Orphan claim re-pointed Claims processor | CLM-420416 → UHC-16437-41 (Bruce Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007877 | Orphan claim re-pointed Claims processor | CLM-427175 → UHC-11698-23 (Jennifer Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007878 | Orphan claim re-pointed Claims processor | CLM-419132 → UHC-16999-76 (Camila Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007879 | Orphan claim re-pointed Claims processor | CLM-411263 → UHC-28602-56 (Adam Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007880 | Orphan claim re-pointed Claims processor | CLM-403160 → UHC-48058-63 (Diana Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007881 | Orphan claim re-pointed Claims processor | CLM-431596 → UHC-58263-31 (Grace Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007882 | Orphan claim re-pointed Claims processor | CLM-410967 → UHC-60957-28 (Carolyn Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007883 | Orphan claim re-pointed Claims processor | CLM-407228 → UHC-90026-30 (Bruce Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007884 | Orphan claim re-pointed Claims processor | CLM-430087 → UHC-35018-52 (Amy Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007885 | Orphan claim re-pointed Claims processor | CLM-416393 → UHC-94650-89 (Eric Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007886 | Orphan claim re-pointed Claims processor | CLM-411557 → UHC-99406-56 (Kelly Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007887 | Orphan claim re-pointed Claims processor | CLM-414959 → UHC-10436-45 (Dennis Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007888 | Orphan claim re-pointed Claims processor | CLM-403664 → UHC-72207-33 (Michelle Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007889 | Orphan claim re-pointed Claims processor | CLM-402086 → UHC-03506-46 (Thomas Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007890 | Orphan claim re-pointed Claims processor | CLM-416815 → UHC-87156-17 (Lori Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007891 | Orphan claim re-pointed Claims processor | CLM-408065 → UHC-23423-50 (Emily Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007892 | Orphan claim re-pointed Claims processor | CLM-401514 → UHC-93092-01 (Kathryn Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007893 | Orphan claim re-pointed Claims processor | CLM-414442 → UHC-64017-72 (Evelyn Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007894 | Orphan claim re-pointed Claims processor | CLM-405863 → UHC-98978-15 (Arthur Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007895 | Orphan claim re-pointed Claims processor | CLM-407889 → UHC-31592-87 (Vincent Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007896 | Orphan claim re-pointed Claims processor | CLM-421356 → UHC-02588-79 (Judith Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007897 | Orphan claim re-pointed Claims processor | CLM-427243 → UHC-47675-96 (Stephen Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007898 | Orphan claim re-pointed Claims processor | CLM-414281 → UHC-54551-93 (Christopher Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007899 | Orphan claim re-pointed Claims processor | CLM-410720 → UHC-40573-29 (Diana Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007900 | Orphan claim re-pointed Claims processor | CLM-406491 → UHC-97353-14 (Chris Johnsn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007901 | Orphan claim re-pointed Claims processor | CLM-429336 → UHC-60478-77 (Laura Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007902 | Orphan claim re-pointed Claims processor | CLM-412069 → UHC-79382-41 (Ruth Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007903 | Orphan claim re-pointed Claims processor | CLM-408532 → UHC-95055-11 (Bandon Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007904 | Orphan claim re-pointed Claims processor | CLM-407177 → UHC-37460-16 (Ahmed Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007905 | Orphan claim re-pointed Claims processor | CLM-402306 → UHC-31694-08 (Steven Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007906 | Orphan claim re-pointed Claims processor | CLM-427257 → UHC-24426-27 (Mateo Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007907 | Orphan claim re-pointed Claims processor | CLM-425899 → UHC-01745-78 (Eric Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007908 | Orphan claim re-pointed Claims processor | CLM-402534 → UHC-23088-75 (Andrea Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007909 | Orphan claim re-pointed Claims processor | CLM-423140 → UHC-21870-52 (Virginia Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007910 | Orphan claim re-pointed Claims processor | CLM-407621 → UHC-88508-68 (Teresa Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007911 | Orphan claim re-pointed Claims processor | CLM-420042 → UHC-98857-93 (Daniel Parker) |
| 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.