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-008562 | Orphan claim re-pointed Claims processor | CLM-416260 → UHC-68676-39 (Heather Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008563 | Orphan claim re-pointed Claims processor | CLM-402317 → UHC-64640-18 (Laura Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008564 | Orphan claim re-pointed Claims processor | CLM-409808 → UHC-50412-25 (Albert Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008565 | Orphan claim re-pointed Claims processor | CLM-429763 → UHC-97923-15 (Nicole Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008566 | Orphan claim re-pointed Claims processor | CLM-420639 → UHC-14177-05 (Daniel McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008567 | Orphan claim re-pointed Claims processor | CLM-401047 → UHC-36281-66 (Christina Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008568 | Orphan claim re-pointed Claims processor | CLM-401198 → UHC-23992-53 (Daniel Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008569 | Orphan claim re-pointed Claims processor | CLM-425851 → UHC-07268-37 (Joshua Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008570 | Orphan claim re-pointed Claims processor | CLM-402760 → UHC-45402-41 (James Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008571 | Orphan claim re-pointed Claims processor | CLM-421563 → UHC-53642-48 (Mason Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008572 | Orphan claim re-pointed Claims processor | CLM-417377 → UHC-54565-76 (Gerald Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008573 | Orphan claim re-pointed Claims processor | CLM-432580 → UHC-77378-20 (Zachary Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008574 | Orphan claim re-pointed Claims processor | CLM-422108 → UHC-97248-72 (Megan Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008575 | Orphan claim re-pointed Claims processor | CLM-405141 → UHC-18138-25 (Steven Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008576 | Orphan claim re-pointed Claims processor | CLM-412106 → UHC-96717-17 (Marilyn Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008577 | Orphan claim re-pointed Claims processor | CLM-405558 → UHC-01436-76 (Maria Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008578 | Orphan claim re-pointed Claims processor | CLM-416246 → UHC-55928-14 (Nicholas Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008579 | Orphan claim re-pointed Claims processor | CLM-411099 → UHC-75178-49 (Catherine Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008580 | Orphan claim re-pointed Claims processor | CLM-428722 → UHC-95208-34 (Danielel Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008581 | Orphan claim re-pointed Claims processor | CLM-406988 → UHC-95867-45 (Mark Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008582 | Orphan claim re-pointed Claims processor | CLM-417414 → UHC-26771-60 (Angela Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008583 | Orphan claim re-pointed Claims processor | CLM-406386 → UHC-07884-13 (Ralph Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008584 | Orphan claim re-pointed Claims processor | CLM-423259 → UHC-59331-75 (Mark Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008585 | Orphan claim re-pointed Claims processor | CLM-407709 → UHC-80345-60 (Michelle Luna) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008586 | Orphan claim re-pointed Claims processor | CLM-429412 → UHC-13009-12 (Raymond Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008587 | Orphan claim re-pointed Claims processor | CLM-400142 → UHC-22408-95 (Judy Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008588 | Orphan claim re-pointed Claims processor | CLM-416157 → UHC-14111-62 (Megan Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008589 | Orphan claim re-pointed Claims processor | CLM-421273 → UHC-78003-20 (Janet Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008590 | Orphan claim re-pointed Claims processor | CLM-409181 → UHC-57423-75 (Brandon Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008591 | Orphan claim re-pointed Claims processor | CLM-411574 → UHC-35660-93 (Julie Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008592 | Orphan claim re-pointed Claims processor | CLM-400893 → UHC-13051-27 (Helen Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008593 | Orphan claim re-pointed Claims processor | CLM-420343 → UHC-68689-28 (Hannah Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008594 | Orphan claim re-pointed Claims processor | CLM-419057 → UHC-05485-85 (Carl Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008595 | Orphan claim re-pointed Claims processor | CLM-426245 → UHC-67463-23 (Heather Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008596 | Orphan claim re-pointed Claims processor | CLM-427377 → UHC-16597-33 (Joyce Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008597 | Orphan claim re-pointed Claims processor | CLM-404957 → UHC-02646-81 (Katherine Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008598 | Orphan claim re-pointed Claims processor | CLM-413802 → UHC-07800-37 (Charlotte Kelyl) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008599 | Orphan claim re-pointed Claims processor | CLM-424203 → UHC-06151-92 (Laura Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008600 | Orphan claim re-pointed Claims processor | CLM-421050 → UHC-74848-26 (Jessica Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008601 | Orphan claim re-pointed Claims processor | CLM-414374 → UHC-06108-11 (Kimberly George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008602 | Orphan claim re-pointed Claims processor | CLM-403066 → UHC-67952-99 (Alexis Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008603 | Orphan claim re-pointed Claims processor | CLM-406236 → UHC-65180-55 (Sharon Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008604 | Orphan claim re-pointed Claims processor | CLM-407836 → UHC-35042-30 (Benjamin Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008605 | Orphan claim re-pointed Claims processor | CLM-416817 → UHC-62520-52 (Sara Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008606 | Orphan claim re-pointed Claims processor | CLM-411425 → UHC-18511-80 (Timoty Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008607 | Orphan claim re-pointed Claims processor | CLM-404631 → UHC-24098-48 (Victoria Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008608 | Orphan claim re-pointed Claims processor | CLM-432241 → UHC-70691-50 (Priya Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008609 | Orphan claim re-pointed Claims processor | CLM-425045 → UHC-81000-44 (Judith Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008610 | Orphan claim re-pointed Claims processor | CLM-430058 → UHC-86842-73 (Christine Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008611 | Orphan claim re-pointed Claims processor | CLM-401352 → UHC-13237-39 (Carolyn Snyder) |
| 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.