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-008662 | Orphan claim re-pointed Claims processor | CLM-432191 → UHC-85757-15 (Justin Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008663 | Orphan claim re-pointed Claims processor | CLM-418635 → UHC-25731-70 (Sophia Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008664 | Orphan claim re-pointed Claims processor | CLM-419771 → UHC-07964-17 (Hannah Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008665 | Orphan claim re-pointed Claims processor | CLM-428155 → UHC-81983-21 (Priia Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008666 | Orphan claim re-pointed Claims processor | CLM-429120 → UHC-50593-59 (Larry Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008667 | Orphan claim re-pointed Claims processor | CLM-432202 → UHC-78395-46 (Megan Pteers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008668 | Orphan claim re-pointed Claims processor | CLM-406539 → UHC-29520-95 (Elizabeth Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008669 | Orphan claim re-pointed Claims processor | CLM-429508 → UHC-98142-18 (Betty Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008670 | Orphan claim re-pointed Claims processor | CLM-401427 → UHC-10897-78 (Amanda Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008671 | Orphan claim re-pointed Claims processor | CLM-409128 → UHC-03846-84 (Larry Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008672 | Orphan claim re-pointed Claims processor | CLM-406317 → UHC-23688-88 (Bobby Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008673 | Orphan claim re-pointed Claims processor | CLM-410335 → UHC-84886-97 (Abigail Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008674 | Orphan claim re-pointed Claims processor | CLM-405251 → UHC-80809-06 (Randy Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008675 | Orphan claim re-pointed Claims processor | CLM-425653 → UHC-16477-05 (Frank Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008676 | Orphan claim re-pointed Claims processor | CLM-403468 → UHC-23339-51 (Wayne Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008677 | Orphan claim re-pointed Claims processor | CLM-407865 → UHC-73125-42 (Denise Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008678 | Orphan claim re-pointed Claims processor | CLM-414946 → UHC-08695-42 (Donna Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008679 | Orphan claim re-pointed Claims processor | CLM-425134 → UHC-90720-81 (Sara Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008680 | Orphan claim re-pointed Claims processor | CLM-422327 → UHC-95958-18 (Christian Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008681 | Orphan claim re-pointed Claims processor | CLM-428350 → UHC-64195-37 (Frances Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008682 | Orphan claim re-pointed Claims processor | CLM-418632 → UHC-41188-15 (Jonathan Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008683 | Orphan claim re-pointed Claims processor | CLM-416501 → UHC-43078-98 (Gary Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008684 | Orphan claim re-pointed Claims processor | CLM-421326 → UHC-10223-53 (Martha Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008685 | Orphan claim re-pointed Claims processor | CLM-429331 → UHC-01702-71 (Maria Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008686 | Orphan claim re-pointed Claims processor | CLM-422250 → UHC-31187-24 (Daniel Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008687 | Orphan claim re-pointed Claims processor | CLM-432123 → UHC-84480-65 (Jerry Day) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008688 | Orphan claim re-pointed Claims processor | CLM-401117 → UHC-18443-30 (Jenny Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008689 | Orphan claim re-pointed Claims processor | CLM-400034 → UHC-83497-59 (Martha Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008690 | Orphan claim re-pointed Claims processor | CLM-415236 → UHC-13034-91 (Jacqueline Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008691 | Orphan claim re-pointed Claims processor | CLM-420708 → UHC-67334-94 (Dennis Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008692 | Orphan claim re-pointed Claims processor | CLM-407002 → UHC-82854-83 (Priya Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008693 | Orphan claim re-pointed Claims processor | CLM-427191 → UHC-95608-45 (Kayla Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008694 | Orphan claim re-pointed Claims processor | CLM-401458 → UHC-91693-71 (Albert Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008695 | Orphan claim re-pointed Claims processor | CLM-417270 → UHC-81821-18 (Lori Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008696 | Orphan claim re-pointed Claims processor | CLM-407629 → UHC-76671-82 (Alexis Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008697 | Orphan claim re-pointed Claims processor | CLM-427547 → UHC-39044-49 (Donna Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008698 | Orphan claim re-pointed Claims processor | CLM-414685 → UHC-29633-39 (Alice Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008699 | Orphan claim re-pointed Claims processor | CLM-411767 → UHC-90090-71 (Alice Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008700 | Orphan claim re-pointed Claims processor | CLM-428214 → UHC-54661-78 (Juan Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008701 | Orphan claim re-pointed Claims processor | CLM-423061 → UHC-42219-38 (Judy Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008702 | Orphan claim re-pointed Claims processor | CLM-402040 → UHC-05685-10 (Mark Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008703 | Orphan claim re-pointed Claims processor | CLM-413628 → UHC-64031-66 (Keith Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008704 | Orphan claim re-pointed Claims processor | CLM-429330 → UHC-01702-71 (Maria Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008705 | Orphan claim re-pointed Claims processor | CLM-407538 → UHC-41415-62 (Virginia Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008706 | Orphan claim re-pointed Claims processor | CLM-422936 → UHC-58050-50 (Susan Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008707 | Orphan claim re-pointed Claims processor | CLM-413020 → UHC-70320-01 (Juan Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008708 | Orphan claim re-pointed Claims processor | CLM-416543 → UHC-29228-29 (Janet Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008709 | Orphan claim re-pointed Claims processor | CLM-417582 → UHC-15384-70 (Andrew Lawis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008710 | Orphan claim re-pointed Claims processor | CLM-421838 → UHC-51782-76 (Zachary Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008711 | Orphan claim re-pointed Claims processor | CLM-430025 → UHC-80712-12 (Natalie Long) |
| 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.