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-007962 | Orphan claim re-pointed Claims processor | CLM-417478 → UHC-98244-27 (Willie Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007963 | Orphan claim re-pointed Claims processor | CLM-423919 → UHC-24459-46 (Alice Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007964 | Orphan claim re-pointed Claims processor | CLM-422009 → UHC-11141-16 (Edward Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007965 | Orphan claim re-pointed Claims processor | CLM-432444 → UHC-56574-44 (Shirley White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007966 | Orphan claim re-pointed Claims processor | CLM-428154 → UHC-03625-33 (Gloria Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007967 | Orphan claim re-pointed Claims processor | CLM-430936 → UHC-93400-76 (Kenneth Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007968 | Orphan claim re-pointed Claims processor | CLM-401502 → UHC-03074-28 (Kimberly Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007969 | Orphan claim re-pointed Claims processor | CLM-407760 → UHC-72896-13 (Paul Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007970 | Orphan claim re-pointed Claims processor | CLM-408302 → UHC-60955-24 (Michelle Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007971 | Orphan claim re-pointed Claims processor | CLM-409954 → UHC-95901-31 (Aaron Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007972 | Orphan claim re-pointed Claims processor | CLM-415173 → UHC-91238-33 (Lisa Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007973 | Orphan claim re-pointed Claims processor | CLM-417116 → UHC-67802-97 (Stephen Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007974 | Orphan claim re-pointed Claims processor | CLM-402820 → UHC-15283-06 (Danielle Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007975 | Orphan claim re-pointed Claims processor | CLM-426415 → UHC-61995-62 (Arthur Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007976 | Orphan claim re-pointed Claims processor | CLM-422590 → UHC-73740-43 (Julie Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007977 | Orphan claim re-pointed Claims processor | CLM-401069 → UHC-43379-66 (Anthony Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007978 | Orphan claim re-pointed Claims processor | CLM-429002 → UHC-90927-74 (Jessica Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007979 | Orphan claim re-pointed Claims processor | CLM-428783 → UHC-55353-42 (Diego Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007980 | Orphan claim re-pointed Claims processor | CLM-407039 → UHC-87211-70 (Judith Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007981 | Orphan claim re-pointed Claims processor | CLM-411940 → UHC-04524-02 (Billy Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007982 | Orphan claim re-pointed Claims processor | CLM-413829 → UHC-49708-56 (Karen Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007983 | Orphan claim re-pointed Claims processor | CLM-415195 → UHC-34852-96 (Kyle Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007984 | Orphan claim re-pointed Claims processor | CLM-422360 → UHC-48426-89 (Brian Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007985 | Orphan claim re-pointed Claims processor | CLM-428385 → UHC-71065-72 (Stephen Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007986 | Orphan claim re-pointed Claims processor | CLM-411680 → UHC-57340-93 (Patrick Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007987 | Orphan claim re-pointed Claims processor | CLM-421746 → UHC-99205-78 (Alan Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007988 | Orphan claim re-pointed Claims processor | CLM-424804 → UHC-30010-11 (Fatima Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007989 | Orphan claim re-pointed Claims processor | CLM-401150 → UHC-81873-91 (Albert Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007990 | Orphan claim re-pointed Claims processor | CLM-404648 → UHC-13806-99 (Mary Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007991 | Orphan claim re-pointed Claims processor | CLM-408299 → UHC-70584-52 (Lisa Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007992 | Orphan claim re-pointed Claims processor | CLM-409492 → UHC-14810-76 (Nathan Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007993 | Orphan claim re-pointed Claims processor | CLM-410309 → UHC-57906-75 (Wei Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007994 | Orphan claim re-pointed Claims processor | CLM-401235 → UHC-19454-66 (Amanda Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007995 | Orphan claim re-pointed Claims processor | CLM-402907 → UHC-56867-96 (Peter Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007996 | Orphan claim re-pointed Claims processor | CLM-409116 → UHC-60845-71 (Eugene Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007997 | Orphan claim re-pointed Claims processor | CLM-420618 → UHC-26240-33 (Nathan Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007998 | Orphan claim re-pointed Claims processor | CLM-413124 → UHC-33748-51 (Frank Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-007999 | Orphan claim re-pointed Claims processor | CLM-425155 → UHC-64681-45 (Brittany Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008000 | Orphan claim re-pointed Claims processor | CLM-418899 → UHC-92693-54 (Joseph Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008001 | Orphan claim re-pointed Claims processor | CLM-417079 → UHC-45620-36 (Ruth Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008002 | Orphan claim re-pointed Claims processor | CLM-403408 → UHC-91099-88 (Virginia Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008003 | Orphan claim re-pointed Claims processor | CLM-406886 → UHC-37564-73 (Donald Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008004 | Orphan claim re-pointed Claims processor | CLM-425050 → UHC-92395-20 (Charles Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008005 | Orphan claim re-pointed Claims processor | CLM-401798 → UHC-41424-77 (Gibson Matthew) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008006 | Orphan claim re-pointed Claims processor | CLM-409641 → UHC-26483-10 (Willie Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008007 | Orphan claim re-pointed Claims processor | CLM-401526 → UHC-44976-64 (Jean Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008008 | Orphan claim re-pointed Claims processor | CLM-416972 → UHC-42690-59 (Jose Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008009 | Orphan claim re-pointed Claims processor | CLM-406483 → UHC-92812-35 (Shirley Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008010 | Orphan claim re-pointed Claims processor | CLM-407905 → UHC-68037-68 (Adam Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008011 | Orphan claim re-pointed Claims processor | CLM-415818 → UHC-57067-49 (Patricia Payne) |
| 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.