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-008612 | Orphan claim re-pointed Claims processor | CLM-414591 → UHC-98819-71 (Vincent Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008613 | Orphan claim re-pointed Claims processor | CLM-421429 → UHC-95248-22 (Maria Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008614 | Orphan claim re-pointed Claims processor | CLM-423705 → UHC-22231-79 (Doris Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008615 | Orphan claim re-pointed Claims processor | CLM-408347 → UHC-21755-58 (Brenda Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008616 | Orphan claim re-pointed Claims processor | CLM-414211 → UHC-45273-71 (Wei Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008617 | Orphan claim re-pointed Claims processor | CLM-407340 → UHC-81776-62 (Joshua Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008618 | Orphan claim re-pointed Claims processor | CLM-403217 → UHC-15513-78 (Priya West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008619 | Orphan claim re-pointed Claims processor | CLM-419970 → UHC-14753-78 (Philip Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008620 | Orphan claim re-pointed Claims processor | CLM-413427 → UHC-90879-93 (Christine James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008621 | Orphan claim re-pointed Claims processor | CLM-402877 → UHC-48897-92 (Amanda Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008622 | Orphan claim re-pointed Claims processor | CLM-400107 → UHC-31175-80 (Charles Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008623 | Orphan claim re-pointed Claims processor | CLM-410936 → UHC-04017-02 (Fatima Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008624 | Orphan claim re-pointed Claims processor | CLM-407981 → UHC-90195-39 (Richard Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008625 | Orphan claim re-pointed Claims processor | CLM-421819 → UHC-93326-04 (Larry Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008626 | Orphan claim re-pointed Claims processor | CLM-428077 → UHC-36316-19 (Patrikk Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008627 | Orphan claim re-pointed Claims processor | CLM-417976 → UHC-67941-70 (Luis Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008628 | Orphan claim re-pointed Claims processor | CLM-418057 → UHC-13686-89 (Brittany Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008629 | Orphan claim re-pointed Claims processor | CLM-418468 → UHC-10619-92 (Brittany Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008630 | Orphan claim re-pointed Claims processor | CLM-404476 → UHC-81889-78 (Billy Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008631 | Orphan claim re-pointed Claims processor | CLM-423328 → UHC-62827-27 (Omar Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008632 | Orphan claim re-pointed Claims processor | CLM-420713 → UHC-11585-25 (Dennis Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008633 | Orphan claim re-pointed Claims processor | CLM-407225 → UHC-96817-98 (Mason Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008634 | Orphan claim re-pointed Claims processor | CLM-425272 → UHC-73410-29 (Roger Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008635 | Orphan claim re-pointed Claims processor | CLM-415413 → UHC-50156-37 (Mariana Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008636 | Orphan claim re-pointed Claims processor | CLM-400616 → UHC-32156-45 (Michelle Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008637 | Orphan claim re-pointed Claims processor | CLM-410732 → UHC-07701-80 (Brian Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008638 | Orphan claim re-pointed Claims processor | CLM-426025 → UHC-93033-26 (Valentina Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008639 | Orphan claim re-pointed Claims processor | CLM-430066 → UHC-64032-36 (Kyle Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008640 | Orphan claim re-pointed Claims processor | CLM-408064 → UHC-23423-50 (Emily Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008641 | Orphan claim re-pointed Claims processor | CLM-413255 → UHC-73410-84 (Thomas Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008642 | Orphan claim re-pointed Claims processor | CLM-423079 → UHC-92111-02 (Gary Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008643 | Orphan claim re-pointed Claims processor | CLM-403559 → UHC-52440-42 (Paul Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008644 | Orphan claim re-pointed Claims processor | CLM-424926 → UHC-97244-05 (Doris Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008645 | Orphan claim re-pointed Claims processor | CLM-412587 → UHC-27721-07 (Denise Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008646 | Orphan claim re-pointed Claims processor | CLM-408121 → UHC-22151-31 (Stephen Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008647 | Orphan claim re-pointed Claims processor | CLM-408644 → UHC-99277-69 (Mateo Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008648 | Orphan claim re-pointed Claims processor | CLM-406782 → UHC-69527-63 (Billy Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008649 | Orphan claim re-pointed Claims processor | CLM-421671 → UHC-26275-22 (Scott Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008650 | Orphan claim re-pointed Claims processor | CLM-414291 → UHC-51047-62 (Virginia Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008651 | Orphan claim re-pointed Claims processor | CLM-401359 → UHC-95131-79 (Barbara Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008652 | Orphan claim re-pointed Claims processor | CLM-407137 → UHC-72667-92 (Jason Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008653 | Orphan claim re-pointed Claims processor | CLM-422422 → UHC-94453-11 (Thomas Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008654 | Orphan claim re-pointed Claims processor | CLM-430528 → UHC-48771-18 (Andrea Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008655 | Orphan claim re-pointed Claims processor | CLM-431188 → UHC-02175-32 (Terry Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008656 | Orphan claim re-pointed Claims processor | CLM-411890 → UHC-60653-85 (Ryan Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008657 | Orphan claim re-pointed Claims processor | CLM-415797 → UHC-93730-80 (Sarah Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008658 | Orphan claim re-pointed Claims processor | CLM-417556 → UHC-25544-03 (Billy Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008659 | Orphan claim re-pointed Claims processor | CLM-417956 → UHC-95539-20 (Roger Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008660 | Orphan claim re-pointed Claims processor | CLM-409094 → UHC-33573-55 (Carlos Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008661 | Orphan claim re-pointed Claims processor | CLM-405717 → UHC-56813-67 (Edwad Vazquez) |
| 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.