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-008312 | Orphan claim re-pointed Claims processor | CLM-408440 → UHC-69808-22 (Ralph Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008313 | Orphan claim re-pointed Claims processor | CLM-421710 → UHC-48513-75 (Sophia Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008314 | Orphan claim re-pointed Claims processor | CLM-430787 → UHC-13878-53 (Brittany Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008315 | Orphan claim re-pointed Claims processor | CLM-422055 → UHC-04258-57 (Gregory Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008316 | Orphan claim re-pointed Claims processor | CLM-430957 → UHC-86667-03 (Omar Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008317 | Orphan claim re-pointed Claims processor | CLM-415667 → UHC-84600-88 (Mei Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008318 | Orphan claim re-pointed Claims processor | CLM-418690 → UHC-19774-93 (Billy Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008319 | Orphan claim re-pointed Claims processor | CLM-431769 → UHC-27459-40 (Jose Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008320 | Orphan claim re-pointed Claims processor | CLM-428296 → UHC-05360-90 (Frank Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008321 | Orphan claim re-pointed Claims processor | CLM-402759 → UHC-45402-41 (James Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008322 | Orphan claim re-pointed Claims processor | CLM-424330 → UHC-06410-25 (Bobby Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008323 | Orphan claim re-pointed Claims processor | CLM-408759 → UHC-91272-09 (Timothy Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008324 | Orphan claim re-pointed Claims processor | CLM-430333 → UHC-46032-06 (Diego Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008325 | Orphan claim re-pointed Claims processor | CLM-411539 → UHC-88359-68 (Joseph Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008326 | Orphan claim re-pointed Claims processor | CLM-402772 → UHC-43257-62 (Joseph Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008327 | Orphan claim re-pointed Claims processor | CLM-424498 → UHC-08368-16 (Kyle Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008328 | Orphan claim re-pointed Claims processor | CLM-409690 → UHC-51326-64 (Kelly Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008329 | Orphan claim re-pointed Claims processor | CLM-401077 → UHC-64081-98 (Angela Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008330 | Orphan claim re-pointed Claims processor | CLM-422346 → UHC-81724-28 (Peter Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008331 | Orphan claim re-pointed Claims processor | CLM-413432 → UHC-38840-31 (Stephanie Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008332 | Orphan claim re-pointed Claims processor | CLM-423358 → UHC-80053-21 (Billy Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008333 | Orphan claim re-pointed Claims processor | CLM-430359 → UHC-77648-76 (Jean Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008334 | Orphan claim re-pointed Claims processor | CLM-414085 → UHC-50829-41 (Evelyn Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008335 | Orphan claim re-pointed Claims processor | CLM-409134 → UHC-78843-89 (Don Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008336 | Orphan claim re-pointed Claims processor | CLM-427432 → UHC-71596-90 (Brittany Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008337 | Orphan claim re-pointed Claims processor | CLM-403644 → UHC-35712-96 (Elijah Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008338 | Orphan claim re-pointed Claims processor | CLM-402939 → UHC-66938-15 (Natalie Gommez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008339 | Orphan claim re-pointed Claims processor | CLM-409807 → UHC-42307-61 (Priya Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008340 | Orphan claim re-pointed Claims processor | CLM-406465 → UHC-73695-03 (Kathleen Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008341 | Orphan claim re-pointed Claims processor | CLM-423198 → UHC-37719-32 (Ralph Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008342 | Orphan claim re-pointed Claims processor | CLM-422746 → UHC-73785-46 (Elizabeth Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008343 | Orphan claim re-pointed Claims processor | CLM-430722 → UHC-97229-55 (Diego Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008344 | Orphan claim re-pointed Claims processor | CLM-418815 → UHC-89046-92 (Richard Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008345 | Orphan claim re-pointed Claims processor | CLM-422822 → UHC-32163-31 (Terry Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008346 | Orphan claim re-pointed Claims processor | CLM-416320 → UHC-50247-35 (Gabriel Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008347 | Orphan claim re-pointed Claims processor | CLM-413438 → UHC-35719-69 (Alan Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008348 | Orphan claim re-pointed Claims processor | CLM-416841 → UHC-62023-38 (Kimberly Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008349 | Orphan claim re-pointed Claims processor | CLM-421894 → UHC-62313-89 (Ethan Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008350 | Orphan claim re-pointed Claims processor | CLM-400494 → UHC-26457-27 (Amanda Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008351 | Orphan claim re-pointed Claims processor | CLM-428790 → UHC-26758-34 (Christina Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008352 | Orphan claim re-pointed Claims processor | CLM-405255 → UHC-12260-84 (Alexis Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008353 | Orphan claim re-pointed Claims processor | CLM-408535 → UHC-70356-45 (Kathy Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008354 | Orphan claim re-pointed Claims processor | CLM-418117 → UHC-49734-04 (Steven Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008355 | Orphan claim re-pointed Claims processor | CLM-430033 → UHC-85512-04 (Keith Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008356 | Orphan claim re-pointed Claims processor | CLM-419293 → UHC-49759-88 (Grace Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008357 | Orphan claim re-pointed Claims processor | CLM-406602 → UHC-82645-48 (Douglas Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008358 | Orphan claim re-pointed Claims processor | CLM-407251 → UHC-73584-46 (Diana Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008359 | Orphan claim re-pointed Claims processor | CLM-408200 → UHC-55258-87 (Theresa Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008360 | Orphan claim re-pointed Claims processor | CLM-412784 → UHC-81624-09 (Christina Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008361 | Orphan claim re-pointed Claims processor | CLM-400917 → UHC-48607-37 (Carl Cruz) |
| 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.