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-008412 | Orphan claim re-pointed Claims processor | CLM-413300 → UHC-20506-45 (Teresa Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008413 | Orphan claim re-pointed Claims processor | CLM-426858 → UHC-27905-48 (Sofia Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008414 | Orphan claim re-pointed Claims processor | CLM-420647 → UHC-69144-34 (Ralph Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008415 | Orphan claim re-pointed Claims processor | CLM-411668 → UHC-34779-09 (Jack Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008416 | Orphan claim re-pointed Claims processor | CLM-406857 → UHC-38256-64 (Thomas Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008417 | Orphan claim re-pointed Claims processor | CLM-419523 → UHC-85777-05 (Peter Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008418 | Orphan claim re-pointed Claims processor | CLM-408622 → UHC-33957-43 (Kyle Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008419 | Orphan claim re-pointed Claims processor | CLM-426717 → UHC-34141-14 (Theresa Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008420 | Orphan claim re-pointed Claims processor | CLM-404443 → UHC-76520-73 (Sandra Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008421 | Orphan claim re-pointed Claims processor | CLM-422574 → UHC-04297-64 (Samantha Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008422 | Orphan claim re-pointed Claims processor | CLM-414611 → UHC-55711-88 (Kathy Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008423 | Orphan claim re-pointed Claims processor | CLM-424559 → UHC-04038-37 (Kimberly Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008424 | Orphan claim re-pointed Claims processor | CLM-419268 → UHC-53669-74 (Bradley Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008425 | Orphan claim re-pointed Claims processor | CLM-417790 → UHC-80007-46 (Wayne Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008426 | Orphan claim re-pointed Claims processor | CLM-420572 → UHC-12915-66 (Austin Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008427 | Orphan claim re-pointed Claims processor | CLM-429567 → UHC-43400-99 (Alexis Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008428 | Orphan claim re-pointed Claims processor | CLM-431955 → UHC-19650-15 (Bevery Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008429 | Orphan claim re-pointed Claims processor | CLM-431247 → UHC-13315-65 (Gregory Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008430 | Orphan claim re-pointed Claims processor | CLM-432651 → UHC-35610-05 (Ommar Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008431 | Orphan claim re-pointed Claims processor | CLM-423427 → UHC-26304-24 (Ralph Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008432 | Orphan claim re-pointed Claims processor | CLM-409165 → UHC-80089-58 (Juan Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008433 | Orphan claim re-pointed Claims processor | CLM-427974 → UHC-05006-39 (Christopher Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008434 | Orphan claim re-pointed Claims processor | CLM-407763 → UHC-02209-49 (Heather Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008435 | Orphan claim re-pointed Claims processor | CLM-417523 → UHC-33844-49 (Michelle Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008436 | Orphan claim re-pointed Claims processor | CLM-419627 → UHC-32260-32 (Timothy Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008437 | Orphan claim re-pointed Claims processor | CLM-411561 → UHC-15893-43 (Hannah Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008438 | Orphan claim re-pointed Claims processor | CLM-406776 → UHC-24250-02 (Carl Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008439 | Orphan claim re-pointed Claims processor | CLM-403519 → UHC-13349-08 (Pamela Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008440 | Orphan claim re-pointed Claims processor | CLM-432145 → UHC-52291-89 (Donna Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008441 | Orphan claim re-pointed Claims processor | CLM-427745 → UHC-59222-88 (Wayne Colman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008442 | Orphan claim re-pointed Claims processor | CLM-401008 → UHC-76027-12 (Jesse Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008443 | Orphan claim re-pointed Claims processor | CLM-430246 → UHC-61619-78 (Brenda Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008444 | Orphan claim re-pointed Claims processor | CLM-409170 → UHC-89679-38 (Sophia Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008445 | Orphan claim re-pointed Claims processor | CLM-429692 → UHC-70178-05 (Ashley Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008446 | Orphan claim re-pointed Claims processor | CLM-411252 → UHC-50303-16 (Nancy Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008447 | Orphan claim re-pointed Claims processor | CLM-423331 → UHC-27643-08 (Paul Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008448 | Orphan claim re-pointed Claims processor | CLM-420365 → UHC-94337-87 (Cynthia Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008449 | Orphan claim re-pointed Claims processor | CLM-429569 → UHC-54608-62 (Christopher Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008450 | Orphan claim re-pointed Claims processor | CLM-403776 → UHC-85597-57 (Nicole Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008451 | Orphan claim re-pointed Claims processor | CLM-409689 → UHC-57574-35 (Megan West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008452 | Orphan claim re-pointed Claims processor | CLM-412496 → UHC-23934-72 (Steven Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008453 | Orphan claim re-pointed Claims processor | CLM-408734 → UHC-49250-28 (Yuki Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008454 | Orphan claim re-pointed Claims processor | CLM-414580 → UHC-32429-71 (Kayla Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008455 | Orphan claim re-pointed Claims processor | CLM-405371 → UHC-82998-58 (Danielle Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008456 | Orphan claim re-pointed Claims processor | CLM-415543 → UHC-61925-07 (Eugene Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008457 | Orphan claim re-pointed Claims processor | CLM-409360 → UHC-34135-53 (Susan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008458 | Orphan claim re-pointed Claims processor | CLM-408133 → UHC-21993-89 (Andrea Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008459 | Orphan claim re-pointed Claims processor | CLM-420845 → UHC-03014-10 (Gary Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008460 | Orphan claim re-pointed Claims processor | CLM-432149 → UHC-69545-33 (Benjamin Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008461 | Orphan claim re-pointed Claims processor | CLM-427746 → UHC-55520-85 (Mark Valdez) |
| 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.