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-008262 | Orphan claim re-pointed Claims processor | CLM-408641 → UHC-99435-72 (Cole Amanda) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008263 | Orphan claim re-pointed Claims processor | CLM-410448 → UHC-64090-94 (Diane Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008264 | Orphan claim re-pointed Claims processor | CLM-400309 → UHC-57287-39 (Martha Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008265 | Orphan claim re-pointed Claims processor | CLM-407290 → UHC-10875-81 (Lisa Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008266 | Orphan claim re-pointed Claims processor | CLM-417791 → UHC-26672-93 (Fatima Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008267 | Orphan claim re-pointed Claims processor | CLM-414417 → UHC-21726-19 (Ronald Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008268 | Orphan claim re-pointed Claims processor | CLM-424647 → UHC-71648-50 (Donna Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008269 | Orphan claim re-pointed Claims processor | CLM-431675 → UHC-74205-24 (Sophia Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008270 | Orphan claim re-pointed Claims processor | CLM-432072 → UHC-98891-36 (Helen Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008271 | Orphan claim re-pointed Claims processor | CLM-425918 → UHC-24880-90 (Lisa Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008272 | Orphan claim re-pointed Claims processor | CLM-410821 → UHC-94742-18 (Teresa Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008273 | Orphan claim re-pointed Claims processor | CLM-408557 → UHC-06060-75 (Jerry Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008274 | Orphan claim re-pointed Claims processor | CLM-414962 → UHC-56461-21 (Lucia Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008275 | Orphan claim re-pointed Claims processor | CLM-403985 → UHC-34189-13 (Ahmed Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008276 | Orphan claim re-pointed Claims processor | CLM-422310 → UHC-34991-32 (Omar Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008277 | Orphan claim re-pointed Claims processor | CLM-403250 → UHC-62413-34 (Carlos Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008278 | Orphan claim re-pointed Claims processor | CLM-401926 → UHC-44692-67 (Daniel Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008279 | Orphan claim re-pointed Claims processor | CLM-407545 → UHC-08444-39 (Juan Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008280 | Orphan claim re-pointed Claims processor | CLM-400783 → UHC-70675-02 (Fatima Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008281 | Orphan claim re-pointed Claims processor | CLM-410989 → UHC-49315-22 (Gerald Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008282 | Orphan claim re-pointed Claims processor | CLM-400474 → UHC-74466-79 (John Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008283 | Orphan claim re-pointed Claims processor | CLM-401429 → UHC-39816-02 (Brian Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008284 | Orphan claim re-pointed Claims processor | CLM-415140 → UHC-79306-09 (Doulas Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008285 | Orphan claim re-pointed Claims processor | CLM-423597 → UHC-16289-79 (Wayne Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008286 | Orphan claim re-pointed Claims processor | CLM-426143 → UHC-12128-03 (Christian Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008287 | Orphan claim re-pointed Claims processor | CLM-415888 → UHC-85719-06 (Alan Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008288 | Orphan claim re-pointed Claims processor | CLM-414890 → UHC-48337-47 (David Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008289 | Orphan claim re-pointed Claims processor | CLM-401880 → UHC-51254-08 (Patricia Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008290 | Orphan claim re-pointed Claims processor | CLM-429832 → UHC-25390-99 (Jesse Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008291 | Orphan claim re-pointed Claims processor | CLM-424529 → UHC-88160-82 (Elijah Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008292 | Orphan claim re-pointed Claims processor | CLM-403835 → UHC-99304-17 (Frank Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008293 | Orphan claim re-pointed Claims processor | CLM-432466 → UHC-22050-94 (Donald Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008294 | Orphan claim re-pointed Claims processor | CLM-404981 → UHC-89911-60 (Linda Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008295 | Orphan claim re-pointed Claims processor | CLM-409662 → UHC-40928-42 (Santiago Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008296 | Orphan claim re-pointed Claims processor | CLM-402466 → UHC-40777-06 (Alexis Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008297 | Orphan claim re-pointed Claims processor | CLM-406868 → UHC-61614-40 (Virginia Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008298 | Orphan claim re-pointed Claims processor | CLM-406578 → UHC-77689-43 (Abigail Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008299 | Orphan claim re-pointed Claims processor | CLM-424937 → UHC-86507-79 (Wayne Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008300 | Orphan claim re-pointed Claims processor | CLM-413149 → UHC-70663-96 (Austin Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008301 | Orphan claim re-pointed Claims processor | CLM-420302 → UHC-30766-82 (Joshua Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008302 | Orphan claim re-pointed Claims processor | CLM-426155 → UHC-11427-28 (Russell Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008303 | Orphan claim re-pointed Claims processor | CLM-423429 → UHC-26304-24 (Ralph Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008304 | Orphan claim re-pointed Claims processor | CLM-423988 → UHC-63308-42 (Denise Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008305 | Orphan claim re-pointed Claims processor | CLM-401026 → UHC-89960-59 (Maria Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008306 | Orphan claim re-pointed Claims processor | CLM-412563 → UHC-11874-06 (Ryan Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008307 | Orphan claim re-pointed Claims processor | CLM-401807 → UHC-05360-87 (Joyce Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008308 | Orphan claim re-pointed Claims processor | CLM-411929 → UHC-12458-11 (Lawrence Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008309 | Orphan claim re-pointed Claims processor | CLM-410673 → UHC-64891-47 (Jeffrey Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008310 | Orphan claim re-pointed Claims processor | CLM-417628 → UHC-91732-23 (Carolyn Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008311 | Orphan claim re-pointed Claims processor | CLM-429254 → UHC-86504-87 (Mei 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.