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-008712 | Orphan claim re-pointed Claims processor | CLM-423847 → UHC-04022-90 (Lauren Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008713 | Orphan claim re-pointed Claims processor | CLM-414998 → UHC-38052-66 (Brenda Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008714 | Orphan claim re-pointed Claims processor | CLM-406627 → UHC-92202-30 (Jacob Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008715 | Orphan claim re-pointed Claims processor | CLM-402924 → UHC-46319-99 (Bettty Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008716 | Orphan claim re-pointed Claims processor | CLM-425798 → UHC-39394-42 (Jordan Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008717 | Orphan claim re-pointed Claims processor | CLM-415953 → UHC-66554-95 (Madison Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008718 | Orphan claim re-pointed Claims processor | CLM-416183 → UHC-44621-94 (David Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008719 | Orphan claim re-pointed Claims processor | CLM-406888 → UHC-96152-36 (Priya Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008720 | Orphan claim re-pointed Claims processor | CLM-417456 → UHC-64924-50 (Danielle Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008721 | Orphan claim re-pointed Claims processor | CLM-405701 → UHC-52121-96 (Amanda Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008722 | Orphan claim re-pointed Claims processor | CLM-423104 → UHC-47867-27 (Megan Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008723 | Orphan claim re-pointed Claims processor | CLM-407084 → UHC-77574-52 (Bryan Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008724 | Orphan claim re-pointed Claims processor | CLM-404796 → UHC-83247-86 (Shirley Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008725 | Orphan claim re-pointed Claims processor | CLM-425830 → UHC-26876-34 (Walter Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008726 | Orphan claim re-pointed Claims processor | CLM-412361 → UHC-06876-95 (Bobby Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008727 | Orphan claim re-pointed Claims processor | CLM-422999 → UHC-98151-85 (Kathleen Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008728 | Orphan claim re-pointed Claims processor | CLM-413102 → UHC-67014-51 (Kelly Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008729 | Orphan claim re-pointed Claims processor | CLM-424347 → UHC-51683-44 (Teresa Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008730 | Orphan claim re-pointed Claims processor | CLM-412701 → UHC-74593-20 (Abigail Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008731 | Orphan claim re-pointed Claims processor | CLM-420113 → UHC-76497-80 (Rebecca Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008732 | Orphan claim re-pointed Claims processor | CLM-422201 → UHC-44361-63 (Henry Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008733 | Orphan claim re-pointed Claims processor | CLM-429028 → UHC-09729-29 (Bradley Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008734 | Orphan claim re-pointed Claims processor | CLM-415757 → UHC-55567-38 (Michael Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008735 | Orphan claim re-pointed Claims processor | CLM-404064 → UHC-57361-78 (Judith Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008736 | Orphan claim re-pointed Claims processor | CLM-424058 → UHC-77797-13 (Nicholas Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008737 | Orphan claim re-pointed Claims processor | CLM-417776 → UHC-42386-79 (Patricia Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008738 | Orphan claim re-pointed Claims processor | CLM-427295 → UHC-77349-09 (Cheryl Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008739 | Orphan claim re-pointed Claims processor | CLM-416662 → UHC-14238-55 (Janice Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008740 | Orphan claim re-pointed Claims processor | CLM-432552 → UHC-77837-25 (Charles Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008741 | Orphan claim re-pointed Claims processor | CLM-414430 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008742 | Orphan claim re-pointed Claims processor | CLM-407611 → UHC-87670-08 (Tyler Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008743 | Orphan claim re-pointed Claims processor | CLM-429164 → UHC-70952-79 (Nathan Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008744 | Orphan claim re-pointed Claims processor | CLM-432240 → UHC-70691-50 (Priya Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008745 | Orphan claim re-pointed Claims processor | CLM-416162 → UHC-94976-33 (Kayla Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008746 | Orphan claim re-pointed Claims processor | CLM-410455 → UHC-04893-31 (Patrick Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008747 | Orphan claim re-pointed Claims processor | CLM-402155 → UHC-13174-25 (Rachel Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008748 | Orphan claim re-pointed Claims processor | CLM-400091 → UHC-64388-48 (Peter Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008749 | Orphan claim re-pointed Claims processor | CLM-417289 → UHC-99756-43 (Jacob Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008750 | Orphan claim re-pointed Claims processor | CLM-419446 → UHC-36954-02 (Amanda Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008751 | Orphan claim re-pointed Claims processor | CLM-421020 → UHC-71391-15 (Alice Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008752 | Orphan claim re-pointed Claims processor | CLM-400209 → UHC-36744-15 (Maria Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008753 | Orphan claim re-pointed Claims processor | CLM-403280 → UHC-79249-04 (Madison Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008754 | Orphan claim re-pointed Claims processor | CLM-418622 → UHC-43015-79 (Scott Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008755 | Orphan claim re-pointed Claims processor | CLM-423974 → UHC-86331-58 (Justin Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008756 | Orphan claim re-pointed Claims processor | CLM-414824 → UHC-24125-50 (John Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008757 | Orphan claim re-pointed Claims processor | CLM-415679 → UHC-09108-69 (Shirley Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008758 | Orphan claim re-pointed Claims processor | CLM-416822 → UHC-45838-06 (Nancy Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008759 | Orphan claim re-pointed Claims processor | CLM-418145 → UHC-08787-13 (Mari Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008760 | Orphan claim re-pointed Claims processor | CLM-412456 → UHC-99311-81 (Wayne Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008761 | Orphan claim re-pointed Claims processor | CLM-402597 → UHC-57841-72 (Jerry Carlson) |
| 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.