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-008362 | Orphan claim re-pointed Claims processor | CLM-411168 → UHC-74741-25 (Jose Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008363 | Orphan claim re-pointed Claims processor | CLM-418558 → UHC-12369-48 (Lauren Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008364 | Orphan claim re-pointed Claims processor | CLM-418603 → UHC-12777-98 (Cynthia Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008365 | Orphan claim re-pointed Claims processor | CLM-412411 → UHC-85895-32 (Andrew Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008366 | Orphan claim re-pointed Claims processor | CLM-412926 → UHC-81455-82 (Sharon Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008367 | Orphan claim re-pointed Claims processor | CLM-405055 → UHC-82910-48 (Ricard Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008368 | Orphan claim re-pointed Claims processor | CLM-429114 → UHC-50353-26 (Santiago Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008369 | Orphan claim re-pointed Claims processor | CLM-413958 → UHC-20227-17 (Diana Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008370 | Orphan claim re-pointed Claims processor | CLM-415488 → UHC-48738-18 (Rebecca Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008371 | Orphan claim re-pointed Claims processor | CLM-419590 → UHC-93478-47 (Nathan Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008372 | Orphan claim re-pointed Claims processor | CLM-426452 → UHC-13952-43 (Margaret Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008373 | Orphan claim re-pointed Claims processor | CLM-428948 → UHC-39871-55 (Vincent Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008374 | Orphan claim re-pointed Claims processor | CLM-413239 → UHC-56193-25 (Joseph Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008375 | Orphan claim re-pointed Claims processor | CLM-430639 → UHC-26050-17 (Beverly Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008376 | Orphan claim re-pointed Claims processor | CLM-409526 → UHC-43618-30 (Elizabeth Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008377 | Orphan claim re-pointed Claims processor | CLM-403487 → UHC-51240-43 (Camila Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008378 | Orphan claim re-pointed Claims processor | CLM-411093 → UHC-82957-73 (Luis Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008379 | Orphan claim re-pointed Claims processor | CLM-429699 → UHC-51125-18 (Douglas Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008380 | Orphan claim re-pointed Claims processor | CLM-428758 → UHC-13138-62 (Gabriel Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008381 | Orphan claim re-pointed Claims processor | CLM-400869 → UHC-88462-16 (Frances Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008382 | Orphan claim re-pointed Claims processor | CLM-403269 → UHC-32602-43 (Joe Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008383 | Orphan claim re-pointed Claims processor | CLM-410116 → UHC-23636-43 (Cheryl Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008384 | Orphan claim re-pointed Claims processor | CLM-425339 → UHC-09489-36 (George Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008385 | Orphan claim re-pointed Claims processor | CLM-428274 → UHC-56282-29 (Pamela Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008386 | Orphan claim re-pointed Claims processor | CLM-431591 → UHC-19660-26 (Ethan Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008387 | Orphan claim re-pointed Claims processor | CLM-416704 → UHC-09067-17 (Maria Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008388 | Orphan claim re-pointed Claims processor | CLM-431336 → UHC-56910-92 (Brian Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008389 | Orphan claim re-pointed Claims processor | CLM-402879 → UHC-33407-72 (Dylan Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008390 | Orphan claim re-pointed Claims processor | CLM-407512 → UHC-03885-49 (Larry Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008391 | Orphan claim re-pointed Claims processor | CLM-406448 → UHC-14837-83 (Heather Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008392 | Orphan claim re-pointed Claims processor | CLM-410757 → UHC-87313-66 (Shirley Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008393 | Orphan claim re-pointed Claims processor | CLM-431425 → UHC-19387-98 (Marcus Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008394 | Orphan claim re-pointed Claims processor | CLM-412805 → UHC-97157-40 (Brittany Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008395 | Orphan claim re-pointed Claims processor | CLM-431839 → UHC-59847-77 (Mason Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008396 | Orphan claim re-pointed Claims processor | CLM-426001 → UHC-96758-59 (Jason Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008397 | Orphan claim re-pointed Claims processor | CLM-400040 → UHC-74188-59 (Logan Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008398 | Orphan claim re-pointed Claims processor | CLM-409122 → UHC-55015-60 (Omar Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008399 | Orphan claim re-pointed Claims processor | CLM-416449 → UHC-83645-72 (Ruth Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008400 | Orphan claim re-pointed Claims processor | CLM-427457 → UHC-15113-79 (Steve Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008401 | Orphan claim re-pointed Claims processor | CLM-415894 → UHC-36112-57 (Diego Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008402 | Orphan claim re-pointed Claims processor | CLM-420824 → UHC-93150-43 (George Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008403 | Orphan claim re-pointed Claims processor | CLM-411784 → UHC-42370-87 (Barbara Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008404 | Orphan claim re-pointed Claims processor | CLM-402951 → UHC-52045-15 (Linda Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008405 | Orphan claim re-pointed Claims processor | CLM-415971 → UHC-67865-24 (Jennifer Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008406 | Orphan claim re-pointed Claims processor | CLM-401988 → UHC-78063-85 (Eugene McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008407 | Orphan claim re-pointed Claims processor | CLM-414303 → UHC-60314-10 (Kathleen Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008408 | Orphan claim re-pointed Claims processor | CLM-406806 → UHC-97214-71 (Patricia Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008409 | Orphan claim re-pointed Claims processor | CLM-410580 → UHC-16606-32 (Jack Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008410 | Orphan claim re-pointed Claims processor | CLM-426305 → UHC-48314-07 (Kathryn Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008411 | Orphan claim re-pointed Claims processor | CLM-418161 → UHC-41583-44 (Joseph Wong) |
| 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.