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-008112 | Orphan claim re-pointed Claims processor | CLM-417360 → UHC-20211-16 (Diane Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008113 | Orphan claim re-pointed Claims processor | CLM-405192 → UHC-46402-70 (Benjamin Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008114 | Orphan claim re-pointed Claims processor | CLM-404535 → UHC-06069-32 (Sofia Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008115 | Orphan claim re-pointed Claims processor | CLM-426764 → UHC-82369-83 (Katherine Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008116 | Orphan claim re-pointed Claims processor | CLM-405003 → UHC-93428-71 (Carl Rihards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008117 | Orphan claim re-pointed Claims processor | CLM-410338 → UHC-62319-26 (Evelyn McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008118 | Orphan claim re-pointed Claims processor | CLM-431092 → UHC-97823-17 (Beverly Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008119 | Orphan claim re-pointed Claims processor | CLM-409382 → UHC-22854-38 (Anna Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008120 | Orphan claim re-pointed Claims processor | CLM-402318 → UHC-64640-18 (Laura Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008121 | Orphan claim re-pointed Claims processor | CLM-402689 → UHC-46381-97 (Madison Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008122 | Orphan claim re-pointed Claims processor | CLM-403017 → UHC-61543-39 (Nancy Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008123 | Orphan claim re-pointed Claims processor | CLM-408638 → UHC-82440-56 (Lori Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008124 | Orphan claim re-pointed Claims processor | CLM-403516 → UHC-32690-49 (Becky West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008125 | Orphan claim re-pointed Claims processor | CLM-426818 → UHC-17778-93 (Stephanie Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008126 | Orphan claim re-pointed Claims processor | CLM-412172 → UHC-97895-36 (Barbara Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008127 | Orphan claim re-pointed Claims processor | CLM-402178 → UHC-92206-60 (Arthur Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008128 | Orphan claim re-pointed Claims processor | CLM-432374 → UHC-12963-51 (Debra Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008129 | Orphan claim re-pointed Claims processor | CLM-426165 → UHC-46118-23 (Natalie Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008130 | Orphan claim re-pointed Claims processor | CLM-426584 → UHC-69270-12 (Stephen Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008131 | Orphan claim re-pointed Claims processor | CLM-429552 → UHC-53608-54 (Anna Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008132 | Orphan claim re-pointed Claims processor | CLM-404161 → UHC-75872-76 (Peter Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008133 | Orphan claim re-pointed Claims processor | CLM-418083 → UHC-77350-19 (Laura Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008134 | Orphan claim re-pointed Claims processor | CLM-427825 → UHC-64152-85 (Donna Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008135 | Orphan claim re-pointed Claims processor | CLM-404653 → UHC-77455-70 (Hannah Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008136 | Orphan claim re-pointed Claims processor | CLM-404710 → UHC-28560-68 (Charles Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008137 | Orphan claim re-pointed Claims processor | CLM-411091 → UHC-97681-70 (Mari Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008138 | Orphan claim re-pointed Claims processor | CLM-429536 → UHC-91248-73 (Arthur Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008139 | Orphan claim re-pointed Claims processor | CLM-411488 → UHC-31330-62 (Joe Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008140 | Orphan claim re-pointed Claims processor | CLM-423877 → UHC-01003-36 (Joshua Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008141 | Orphan claim re-pointed Claims processor | CLM-428303 → UHC-42987-12 (Brittany Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008142 | Orphan claim re-pointed Claims processor | CLM-410420 → UHC-92906-33 (Sara Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008143 | Orphan claim re-pointed Claims processor | CLM-408625 → UHC-26618-68 (Betty Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008144 | Orphan claim re-pointed Claims processor | CLM-415804 → UHC-94480-70 (Mary Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008145 | Orphan claim re-pointed Claims processor | CLM-420167 → UHC-88779-73 (Sue Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008146 | Orphan claim re-pointed Claims processor | CLM-420230 → UHC-78016-26 (Lawrence Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008147 | Orphan claim re-pointed Claims processor | CLM-421985 → UHC-15116-96 (Jesse Balck) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008148 | Orphan claim re-pointed Claims processor | CLM-405355 → UHC-77760-37 (Sophia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008149 | Orphan claim re-pointed Claims processor | CLM-400468 → UHC-43822-84 (Virginia Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008150 | Orphan claim re-pointed Claims processor | CLM-424657 → UHC-91228-72 (Frank Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008151 | Orphan claim re-pointed Claims processor | CLM-430211 → UHC-63930-87 (Alan Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008152 | Orphan claim re-pointed Claims processor | CLM-426481 → UHC-87593-18 (Teresa Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008153 | Orphan claim re-pointed Claims processor | CLM-428833 → UHC-76258-52 (Roger Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008154 | Orphan claim re-pointed Claims processor | CLM-426674 → UHC-30099-24 (Carlos Sttewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008155 | Orphan claim re-pointed Claims processor | CLM-428398 → UHC-37392-76 (Heather Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008156 | Orphan claim re-pointed Claims processor | CLM-415470 → UHC-23648-90 (Natalie Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008157 | Orphan claim re-pointed Claims processor | CLM-408356 → UHC-50549-37 (Camila Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008158 | Orphan claim re-pointed Claims processor | CLM-422897 → UHC-11424-61 (Jean Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008159 | Orphan claim re-pointed Claims processor | CLM-428843 → UHC-67988-31 (Peter Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008160 | Orphan claim re-pointed Claims processor | CLM-429189 → UHC-54998-45 (Sara Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008161 | Orphan claim re-pointed Claims processor | CLM-423403 → UHC-41069-52 (Carolyn Martin) |
| 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.