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-008462 | Orphan claim re-pointed Claims processor | CLM-413624 → UHC-21997-61 (Eric Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008463 | Orphan claim re-pointed Claims processor | CLM-428243 → UHC-44389-59 (Jacqueline West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008464 | Orphan claim re-pointed Claims processor | CLM-430475 → UHC-58815-25 (Vincent Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008465 | Orphan claim re-pointed Claims processor | CLM-412839 → UHC-15044-36 (Ryan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008466 | Orphan claim re-pointed Claims processor | CLM-402982 → UHC-22125-14 (Kevin Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008467 | Orphan claim re-pointed Claims processor | CLM-418650 → UHC-92169-35 (Billy Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008468 | Orphan claim re-pointed Claims processor | CLM-416303 → UHC-44423-90 (Philip Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008469 | Orphan claim re-pointed Claims processor | CLM-428665 → UHC-30839-28 (Beverly Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008470 | Orphan claim re-pointed Claims processor | CLM-402659 → UHC-35142-11 (Nathan McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008471 | Orphan claim re-pointed Claims processor | CLM-423430 → UHC-26304-24 (Ralph Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008472 | Orphan claim re-pointed Claims processor | CLM-429734 → UHC-57646-71 (Ralph Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008473 | Orphan claim re-pointed Claims processor | CLM-412012 → UHC-53248-15 (Santiago Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008474 | Orphan claim re-pointed Claims processor | CLM-400063 → UHC-95544-56 (Christian Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008475 | Orphan claim re-pointed Claims processor | CLM-404744 → UHC-57000-99 (Alexander Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008476 | Orphan claim re-pointed Claims processor | CLM-424773 → UHC-03381-49 (Andrea Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008477 | Orphan claim re-pointed Claims processor | CLM-424445 → UHC-64561-81 (Charles Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008478 | Orphan claim re-pointed Claims processor | CLM-409783 → UHC-29887-60 (Grace Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008479 | Orphan claim re-pointed Claims processor | CLM-406017 → UHC-32609-65 (Deborah Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008480 | Orphan claim re-pointed Claims processor | CLM-407346 → UHC-31271-01 (Therasa Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008481 | Orphan claim re-pointed Claims processor | CLM-429883 → UHC-68447-74 (Valentina Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008482 | Orphan claim re-pointed Claims processor | CLM-419336 → UHC-38763-55 (Janice Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008483 | Orphan claim re-pointed Claims processor | CLM-424282 → UHC-99478-30 (Katherine Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008484 | Orphan claim re-pointed Claims processor | CLM-425443 → UHC-88416-78 (Maria Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008485 | Orphan claim re-pointed Claims processor | CLM-428127 → UHC-29043-03 (Roy Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008486 | Orphan claim re-pointed Claims processor | CLM-414911 → UHC-89766-39 (Dennis Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008487 | Orphan claim re-pointed Claims processor | CLM-421534 → UHC-20670-78 (Kelly Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008488 | Orphan claim re-pointed Claims processor | CLM-403933 → UHC-80073-60 (Logan Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008489 | Orphan claim re-pointed Claims processor | CLM-421493 → UHC-99018-57 (Billy Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008490 | Orphan claim re-pointed Claims processor | CLM-418706 → UHC-99974-48 (Keith Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008491 | Orphan claim re-pointed Claims processor | CLM-431479 → UHC-34676-78 (Ana Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008492 | Orphan claim re-pointed Claims processor | CLM-432791 → UHC-43773-54 (Nancy Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008493 | Orphan claim re-pointed Claims processor | CLM-403650 → UHC-01047-48 (Rebecca Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008494 | Orphan claim re-pointed Claims processor | CLM-400841 → UHC-50508-51 (Nancy Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008495 | Orphan claim re-pointed Claims processor | CLM-406089 → UHC-41869-67 (Nathan Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008496 | Orphan claim re-pointed Claims processor | CLM-428835 → UHC-49913-33 (Sharon Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008497 | Orphan claim re-pointed Claims processor | CLM-431351 → UHC-46415-43 (Richard Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008498 | Orphan claim re-pointed Claims processor | CLM-429914 → UHC-00025-27 (Susan Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008499 | Orphan claim re-pointed Claims processor | CLM-427542 → UHC-28198-68 (Marilyn George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008500 | Orphan claim re-pointed Claims processor | CLM-421665 → UHC-59345-92 (Kimberly Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008501 | Orphan claim re-pointed Claims processor | CLM-406388 → UHC-25353-07 (Wei Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008502 | Orphan claim re-pointed Claims processor | CLM-418949 → UHC-09366-25 (Eugene Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008503 | Orphan claim re-pointed Claims processor | CLM-414333 → UHC-18863-52 (Mariana Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008504 | Orphan claim re-pointed Claims processor | CLM-413443 → UHC-77657-84 (Helen Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008505 | Orphan claim re-pointed Claims processor | CLM-401914 → UHC-01025-68 (Sharon Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008506 | Orphan claim re-pointed Claims processor | CLM-403318 → UHC-44901-09 (Teresa Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008507 | Orphan claim re-pointed Claims processor | CLM-431342 → UHC-31508-89 (Kayla Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008508 | Orphan claim re-pointed Claims processor | CLM-427028 → UHC-89619-29 (Doris Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008509 | Orphan claim re-pointed Claims processor | CLM-430965 → UHC-19301-15 (Luis Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008510 | Orphan claim re-pointed Claims processor | CLM-423466 → UHC-79194-93 (Ana Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008511 | Orphan claim re-pointed Claims processor | CLM-430026 → UHC-82268-47 (Carolyn Li) |
| 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.