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-008062 | Orphan claim re-pointed Claims processor | CLM-411927 → UHC-58014-70 (Kimberly Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008063 | Orphan claim re-pointed Claims processor | CLM-421595 → UHC-61139-77 (Maria Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008064 | Orphan claim re-pointed Claims processor | CLM-415693 → UHC-62566-01 (Bryan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008065 | Orphan claim re-pointed Claims processor | CLM-430128 → UHC-80701-58 (Melissa Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008066 | Orphan claim re-pointed Claims processor | CLM-402866 → UHC-27784-32 (Kimberly Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008067 | Orphan claim re-pointed Claims processor | CLM-423048 → UHC-50559-22 (Alan Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008068 | Orphan claim re-pointed Claims processor | CLM-411683 → UHC-00056-21 (Catherine Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008069 | Orphan claim re-pointed Claims processor | CLM-419876 → UHC-30578-85 (Mariana Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008070 | Orphan claim re-pointed Claims processor | CLM-424921 → UHC-14134-97 (Frances Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008071 | Orphan claim re-pointed Claims processor | CLM-427149 → UHC-96541-82 (Michael Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008072 | Orphan claim re-pointed Claims processor | CLM-411908 → UHC-95529-48 (Emily Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008073 | Orphan claim re-pointed Claims processor | CLM-421084 → UHC-32126-56 (Rebecca Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008074 | Orphan claim re-pointed Claims processor | CLM-402638 → UHC-70484-11 (Donna Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008075 | Orphan claim re-pointed Claims processor | CLM-418034 → UHC-77509-21 (William Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008076 | Orphan claim re-pointed Claims processor | CLM-412301 → UHC-47768-24 (Jacob Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008077 | Orphan claim re-pointed Claims processor | CLM-405217 → UHC-80110-73 (Carol Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008078 | Orphan claim re-pointed Claims processor | CLM-409491 → UHC-60276-16 (Mariana Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008079 | Orphan claim re-pointed Claims processor | CLM-403779 → UHC-34868-16 (Dylan Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008080 | Orphan claim re-pointed Claims processor | CLM-420356 → UHC-17172-85 (Jesse Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008081 | Orphan claim re-pointed Claims processor | CLM-412297 → UHC-94068-18 (Kevin Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008082 | Orphan claim re-pointed Claims processor | CLM-418301 → UHC-91495-71 (Don Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008083 | Orphan claim re-pointed Claims processor | CLM-417683 → UHC-44398-20 (Eugene Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008084 | Orphan claim re-pointed Claims processor | CLM-427843 → UHC-99194-43 (Carol Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008085 | Orphan claim re-pointed Claims processor | CLM-416062 → UHC-95205-05 (Donald Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008086 | Orphan claim re-pointed Claims processor | CLM-426638 → UHC-19828-47 (Roy Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008087 | Orphan claim re-pointed Claims processor | CLM-407566 → UHC-87035-55 (Thomas Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008088 | Orphan claim re-pointed Claims processor | CLM-419428 → UHC-36002-70 (Shirley Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008089 | Orphan claim re-pointed Claims processor | CLM-406840 → UHC-53925-63 (Jacob Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008090 | Orphan claim re-pointed Claims processor | CLM-431472 → UHC-12167-44 (Carolyn Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008091 | Orphan claim re-pointed Claims processor | CLM-401820 → UHC-64480-79 (Jonathan Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008092 | Orphan claim re-pointed Claims processor | CLM-423731 → UHC-61347-45 (Teresa Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008093 | Orphan claim re-pointed Claims processor | CLM-432173 → UHC-52800-45 (Alice Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008094 | Orphan claim re-pointed Claims processor | CLM-419127 → UHC-70586-14 (Ethan Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008095 | Orphan claim re-pointed Claims processor | CLM-409528 → UHC-50046-10 (Matthew Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008096 | Orphan claim re-pointed Claims processor | CLM-404515 → UHC-29058-69 (Deborah Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008097 | Orphan claim re-pointed Claims processor | CLM-413643 → UHC-71517-82 (Lauren Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008098 | Orphan claim re-pointed Claims processor | CLM-418228 → UHC-34231-80 (Omar Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008099 | Orphan claim re-pointed Claims processor | CLM-400324 → UHC-47701-51 (Edward Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008100 | Orphan claim re-pointed Claims processor | CLM-408976 → UHC-27676-63 (Nicole Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008101 | Orphan claim re-pointed Claims processor | CLM-428496 → UHC-27495-29 (Priya Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008102 | Orphan claim re-pointed Claims processor | CLM-423029 → UHC-34532-34 (Ruth Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008103 | Orphan claim re-pointed Claims processor | CLM-404633 → UHC-19228-66 (Deborah Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008104 | Orphan claim re-pointed Claims processor | CLM-416461 → UHC-16686-90 (Jonathan Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008105 | Orphan claim re-pointed Claims processor | CLM-419286 → UHC-03266-71 (Amber Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008106 | Orphan claim re-pointed Claims processor | CLM-419139 → UHC-31227-73 (Keith Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008107 | Orphan claim re-pointed Claims processor | CLM-407086 → UHC-44422-88 (Ralph Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008108 | Orphan claim re-pointed Claims processor | CLM-408255 → UHC-95675-57 (Kayla Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008109 | Orphan claim re-pointed Claims processor | CLM-404185 → UHC-37788-27 (Melissa Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008110 | Orphan claim re-pointed Claims processor | CLM-428378 → UHC-91491-21 (Cheryl Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008111 | Orphan claim re-pointed Claims processor | CLM-402793 → UHC-16351-42 (Daniel Rios) |
| 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.