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-008012 | Orphan claim re-pointed Claims processor | CLM-409244 → UHC-78323-03 (Emma Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008013 | Orphan claim re-pointed Claims processor | CLM-416151 → UHC-57771-75 (Nancy Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008014 | Orphan claim re-pointed Claims processor | CLM-429417 → UHC-76690-56 (Douglas Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008015 | Orphan claim re-pointed Claims processor | CLM-401994 → UHC-64409-56 (Alexis Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008016 | Orphan claim re-pointed Claims processor | CLM-402606 → UHC-39005-14 (Albert Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008017 | Orphan claim re-pointed Claims processor | CLM-409596 → UHC-86332-25 (Albert Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008018 | Orphan claim re-pointed Claims processor | CLM-411986 → UHC-77522-55 (Christine Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008019 | Orphan claim re-pointed Claims processor | CLM-424026 → UHC-80684-62 (Susan Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008020 | Orphan claim re-pointed Claims processor | CLM-411618 → UHC-99981-18 (Olivia Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008021 | Orphan claim re-pointed Claims processor | CLM-408268 → UHC-15361-15 (Rachel Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008022 | Orphan claim re-pointed Claims processor | CLM-425335 → UHC-51560-94 (Marc Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008023 | Orphan claim re-pointed Claims processor | CLM-404848 → UHC-87366-39 (Frank Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008024 | Orphan claim re-pointed Claims processor | CLM-400258 → UHC-64801-14 (Daniel Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008025 | Orphan claim re-pointed Claims processor | CLM-416970 → UHC-76907-92 (Ana Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008026 | Orphan claim re-pointed Claims processor | CLM-413591 → UHC-13835-02 (Mark Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008027 | Orphan claim re-pointed Claims processor | CLM-413163 → UHC-71582-77 (Janice Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008028 | Orphan claim re-pointed Claims processor | CLM-415209 → UHC-59243-54 (Bobby Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008029 | Orphan claim re-pointed Claims processor | CLM-408436 → UHC-85118-52 (Ryan Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008030 | Orphan claim re-pointed Claims processor | CLM-410864 → UHC-03070-53 (Jacqueline Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008031 | Orphan claim re-pointed Claims processor | CLM-400924 → UHC-21483-29 (Peter Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008032 | Orphan claim re-pointed Claims processor | CLM-419528 → UHC-50005-94 (Billy Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008033 | Orphan claim re-pointed Claims processor | CLM-411782 → UHC-52569-74 (Sofia Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008034 | Orphan claim re-pointed Claims processor | CLM-405737 → UHC-46437-23 (Christopher Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008035 | Orphan claim re-pointed Claims processor | CLM-406831 → UHC-81204-88 (Brian Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008036 | Orphan claim re-pointed Claims processor | CLM-403330 → UHC-81477-97 (Teresa Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008037 | Orphan claim re-pointed Claims processor | CLM-428311 → UHC-76482-85 (Matthew Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008038 | Orphan claim re-pointed Claims processor | CLM-426250 → UHC-23257-02 (Kevin Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008039 | Orphan claim re-pointed Claims processor | CLM-424479 → UHC-78069-86 (Bryan Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008040 | Orphan claim re-pointed Claims processor | CLM-418752 → UHC-91877-89 (Joshua Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008041 | Orphan claim re-pointed Claims processor | CLM-401086 → UHC-83499-60 (Pamela Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008042 | Orphan claim re-pointed Claims processor | CLM-432122 → UHC-20509-49 (Christopher Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008043 | Orphan claim re-pointed Claims processor | CLM-421280 → UHC-93575-40 (Susan Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008044 | Orphan claim re-pointed Claims processor | CLM-425289 → UHC-88409-01 (Keith Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008045 | Orphan claim re-pointed Claims processor | CLM-414645 → UHC-61789-32 (Brittany Harveey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008046 | Orphan claim re-pointed Claims processor | CLM-426702 → UHC-60712-61 (Philip Fergusson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008047 | Orphan claim re-pointed Claims processor | CLM-402326 → UHC-60553-97 (Russell Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008048 | Orphan claim re-pointed Claims processor | CLM-417818 → UHC-51268-55 (Ralph Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008049 | Orphan claim re-pointed Claims processor | CLM-409968 → UHC-08632-94 (Henry Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008050 | Orphan claim re-pointed Claims processor | CLM-400969 → UHC-44065-22 (Megan Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008051 | Orphan claim re-pointed Claims processor | CLM-431513 → UHC-96067-72 (Lisa Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008052 | Orphan claim re-pointed Claims processor | CLM-413861 → UHC-99208-18 (Juan Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008053 | Orphan claim re-pointed Claims processor | CLM-404236 → UHC-67242-55 (Christian Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008054 | Orphan claim re-pointed Claims processor | CLM-413615 → UHC-37470-27 (Henry Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008055 | Orphan claim re-pointed Claims processor | CLM-427805 → UHC-28878-34 (Ronald Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008056 | Orphan claim re-pointed Claims processor | CLM-420995 → UHC-50500-21 (Ruth Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008057 | Orphan claim re-pointed Claims processor | CLM-414923 → UHC-94263-23 (Kathryn Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008058 | Orphan claim re-pointed Claims processor | CLM-415995 → UHC-99915-26 (Lawrrence Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008059 | Orphan claim re-pointed Claims processor | CLM-402096 → UHC-71629-03 (Charlotte Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008060 | Orphan claim re-pointed Claims processor | CLM-423769 → UHC-28497-69 (Virginia Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008061 | Orphan claim re-pointed Claims processor | CLM-405107 → UHC-64703-56 (Mary Miller) |
| 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.