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-007912 | Orphan claim re-pointed Claims processor | CLM-425637 → UHC-17938-96 (Maggie Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007913 | Orphan claim re-pointed Claims processor | CLM-401202 → UHC-55315-51 (Maria Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007914 | Orphan claim re-pointed Claims processor | CLM-412788 → UHC-38991-46 (Vincent Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007915 | Orphan claim re-pointed Claims processor | CLM-400881 → UHC-45348-02 (Janet Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007916 | Orphan claim re-pointed Claims processor | CLM-413787 → UHC-01066-48 (Alice Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007917 | Orphan claim re-pointed Claims processor | CLM-401070 → UHC-94818-41 (Eric Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007918 | Orphan claim re-pointed Claims processor | CLM-410654 → UHC-76049-74 (Terry Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007919 | Orphan claim re-pointed Claims processor | CLM-418832 → UHC-92550-82 (Dorothy Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007920 | Orphan claim re-pointed Claims processor | CLM-414921 → UHC-94194-72 (Jessica Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007921 | Orphan claim re-pointed Claims processor | CLM-401239 → UHC-14538-84 (Charlotte Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007922 | Orphan claim re-pointed Claims processor | CLM-402829 → UHC-40229-12 (Bruce Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007923 | Orphan claim re-pointed Claims processor | CLM-415844 → UHC-54643-62 (Eric Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007924 | Orphan claim re-pointed Claims processor | CLM-404046 → UHC-23825-89 (Alan Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007925 | Orphan claim re-pointed Claims processor | CLM-424625 → UHC-43768-55 (Diana Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007926 | Orphan claim re-pointed Claims processor | CLM-429676 → UHC-89354-81 (Madison Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007927 | Orphan claim re-pointed Claims processor | CLM-410852 → UHC-24551-29 (Kayla Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007928 | Orphan claim re-pointed Claims processor | CLM-425924 → UHC-36079-65 (Abigail Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007929 | Orphan claim re-pointed Claims processor | CLM-419337 → UHC-85345-13 (Fatima Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007930 | Orphan claim re-pointed Claims processor | CLM-424393 → UHC-20229-57 (Joyce Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007931 | Orphan claim re-pointed Claims processor | CLM-406351 → UHC-40218-11 (Angela Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007932 | Orphan claim re-pointed Claims processor | CLM-420919 → UHC-50807-87 (Jacqueline Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007933 | Orphan claim re-pointed Claims processor | CLM-427884 → UHC-60255-97 (Sara Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007934 | Orphan claim re-pointed Claims processor | CLM-415443 → UHC-99010-79 (Samuel Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007935 | Orphan claim re-pointed Claims processor | CLM-414382 → UHC-74612-63 (Ashley Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007936 | Orphan claim re-pointed Claims processor | CLM-414898 → UHC-70540-52 (Sandra Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007937 | Orphan claim re-pointed Claims processor | CLM-415706 → UHC-13517-15 (Amy Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007938 | Orphan claim re-pointed Claims processor | CLM-414455 → UHC-89605-89 (Matthew Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007939 | Orphan claim re-pointed Claims processor | CLM-410183 → UHC-84336-69 (Aaln Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007940 | Orphan claim re-pointed Claims processor | CLM-403582 → UHC-37893-53 (Frank Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007941 | Orphan claim re-pointed Claims processor | CLM-425250 → UHC-64045-26 (Ethan Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007942 | Orphan claim re-pointed Claims processor | CLM-416547 → UHC-57787-63 (Amy Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007943 | Orphan claim re-pointed Claims processor | CLM-413299 → UHC-07280-86 (Ortega Brandon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007944 | Orphan claim re-pointed Claims processor | CLM-430352 → UHC-68668-91 (Aaron Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007945 | Orphan claim re-pointed Claims processor | CLM-426150 → UHC-70332-22 (Eric Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007946 | Orphan claim re-pointed Claims processor | CLM-401565 → UHC-32875-15 (Vincent Goerge) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007947 | Orphan claim re-pointed Claims processor | CLM-408590 → UHC-34242-48 (George Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007948 | Orphan claim re-pointed Claims processor | CLM-408917 → UHC-91233-31 (Jim Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007949 | Orphan claim re-pointed Claims processor | CLM-432534 → UHC-49764-44 (Steven Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007950 | Orphan claim re-pointed Claims processor | CLM-403382 → UHC-24356-58 (Debra Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007951 | Orphan claim re-pointed Claims processor | CLM-413368 → UHC-50684-24 (Rachel Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007952 | Orphan claim re-pointed Claims processor | CLM-422132 → UHC-48138-76 (Samuel Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007953 | Orphan claim re-pointed Claims processor | CLM-411965 → UHC-44995-70 (Frances Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007954 | Orphan claim re-pointed Claims processor | CLM-410680 → UHC-70285-55 (Bobby Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007955 | Orphan claim re-pointed Claims processor | CLM-418359 → UHC-62516-28 (Dorothy Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007956 | Orphan claim re-pointed Claims processor | CLM-426641 → UHC-16029-61 (Julie Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007957 | Orphan claim re-pointed Claims processor | CLM-414060 → UHC-08984-12 (Tyler Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007958 | Orphan claim re-pointed Claims processor | CLM-402701 → UHC-53226-29 (Gloria Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007959 | Orphan claim re-pointed Claims processor | CLM-422257 → UHC-39880-08 (Christina Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007960 | Orphan claim re-pointed Claims processor | CLM-418113 → UHC-95097-30 (Arthur Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007961 | Orphan claim re-pointed Claims processor | CLM-414033 → UHC-48398-94 (James Yang) |
| 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.