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-008812 | Orphan claim re-pointed Claims processor | CLM-421516 → UHC-47416-37 (Dylan Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008813 | Orphan claim re-pointed Claims processor | CLM-414109 → UHC-26336-25 (Walter Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008814 | Orphan claim re-pointed Claims processor | CLM-413854 → UHC-75927-48 (Karen Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008815 | Orphan claim re-pointed Claims processor | CLM-431662 → UHC-83196-09 (James Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008816 | Orphan claim re-pointed Claims processor | CLM-425210 → UHC-69833-28 (Helen Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008817 | Orphan claim re-pointed Claims processor | CLM-419746 → UHC-48953-93 (Tyler Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008818 | Orphan claim re-pointed Claims processor | CLM-405036 → UHC-07597-48 (Carlos Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008819 | Orphan claim re-pointed Claims processor | CLM-415732 → UHC-52616-48 (William Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008820 | Orphan claim re-pointed Claims processor | CLM-400036 → UHC-48669-35 (Omar Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008821 | Orphan claim re-pointed Claims processor | CLM-424002 → UHC-48367-52 (Willie Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008822 | Orphan claim re-pointed Claims processor | CLM-415809 → UHC-24101-25 (Fatima Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008823 | Orphan claim re-pointed Claims processor | CLM-403777 → UHC-85597-57 (Nicole Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008824 | Orphan claim re-pointed Claims processor | CLM-422904 → UHC-24119-60 (Eugene Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008825 | Orphan claim re-pointed Claims processor | CLM-402620 → UHC-69723-76 (Julie Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008826 | Orphan claim re-pointed Claims processor | CLM-422991 → UHC-73466-21 (Joe Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008827 | Orphan claim re-pointed Claims processor | CLM-419110 → UHC-67085-21 (Brian Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008828 | Orphan claim re-pointed Claims processor | CLM-402316 → UHC-64640-18 (Laura Alvarado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008829 | Orphan claim re-pointed Claims processor | CLM-419732 → UHC-05699-88 (Donna Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008830 | Orphan claim re-pointed Claims processor | CLM-417294 → UHC-60299-61 (Paul Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008831 | Orphan claim re-pointed Claims processor | CLM-428363 → UHC-84690-46 (Bradley Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008832 | Orphan claim re-pointed Claims processor | CLM-401377 → UHC-37963-95 (Kathryn Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008833 | Orphan claim re-pointed Claims processor | CLM-428054 → UHC-28654-06 (Sharon Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008834 | Orphan claim re-pointed Claims processor | CLM-432453 → UHC-56127-37 (Douglas Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008835 | Orphan claim re-pointed Claims processor | CLM-429449 → UHC-73700-75 (Christina Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008836 | Orphan claim re-pointed Claims processor | CLM-425652 → UHC-69000-23 (Lisa Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008837 | Orphan claim re-pointed Claims processor | CLM-416140 → UHC-61680-99 (Karen Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008838 | Orphan claim re-pointed Claims processor | CLM-416522 → UHC-44389-91 (Grace Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008839 | Orphan claim re-pointed Claims processor | CLM-408825 → UHC-88397-72 (Charlotte Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008840 | Orphan claim re-pointed Claims processor | CLM-411165 → UHC-69990-78 (Kevin Soot) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008841 | Orphan claim re-pointed Claims processor | CLM-404274 → UHC-75366-47 (Andrea Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008842 | Orphan claim re-pointed Claims processor | CLM-406498 → UHC-76329-93 (Cynthia Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008843 | Orphan claim re-pointed Claims processor | CLM-416936 → UHC-16493-18 (Amber Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008844 | Orphan claim re-pointed Claims processor | CLM-419847 → UHC-79045-67 (Amy Gonzaales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008845 | Orphan claim re-pointed Claims processor | CLM-403186 → UHC-21353-27 (Yuki Herrera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008846 | Orphan claim re-pointed Claims processor | CLM-409741 → UHC-49250-90 (Charles Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008847 | Orphan claim re-pointed Claims processor | CLM-405375 → UHC-20937-43 (Sara Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008848 | Orphan claim re-pointed Claims processor | CLM-416367 → UHC-43821-91 (Mary Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008849 | Orphan claim re-pointed Claims processor | CLM-404538 → UHC-88580-44 (Lisa Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008850 | Orphan claim re-pointed Claims processor | CLM-419327 → UHC-68157-21 (Ann Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008851 | Orphan claim re-pointed Claims processor | CLM-427802 → UHC-43089-48 (Debra Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008852 | Orphan claim re-pointed Claims processor | CLM-418778 → UHC-93141-48 (Juan Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008853 | Orphan claim re-pointed Claims processor | CLM-400657 → UHC-49481-03 (Margaret Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008854 | Orphan claim re-pointed Claims processor | CLM-417513 → UHC-64553-99 (Russell Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008855 | Orphan claim re-pointed Claims processor | CLM-422421 → UHC-94453-11 (Thomas Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008856 | Orphan claim re-pointed Claims processor | CLM-424423 → UHC-40750-03 (Amy Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008857 | Orphan claim re-pointed Claims processor | CLM-410204 → UHC-71698-20 (Julia Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008858 | Orphan claim re-pointed Claims processor | CLM-405828 → UHC-00903-59 (Grace Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008859 | Orphan claim re-pointed Claims processor | CLM-426698 → UHC-39362-82 (Dennis Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008860 | Orphan claim re-pointed Claims processor | CLM-414404 → UHC-68640-21 (Dennis Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008861 | Orphan claim re-pointed Claims processor | CLM-425967 → UHC-84938-93 (Sophia Walker) |
| 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.