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-008912 | Orphan claim re-pointed Claims processor | CLM-406268 → UHC-99893-15 (Fatima Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008913 | Orphan claim re-pointed Claims processor | CLM-428489 → UHC-71793-40 (Beverly Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008914 | Orphan claim re-pointed Claims processor | CLM-429184 → UHC-67446-61 (Luis Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008915 | Orphan claim re-pointed Claims processor | CLM-401616 → UHC-96989-32 (Sophia Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008916 | Orphan claim re-pointed Claims processor | CLM-422032 → UHC-17963-76 (Brian Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008917 | Orphan claim re-pointed Claims processor | CLM-408392 → UHC-54563-08 (Ashley Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008918 | Orphan claim re-pointed Claims processor | CLM-400374 → UHC-12398-94 (Gloria Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008919 | Orphan claim re-pointed Claims processor | CLM-432549 → UHC-03633-88 (Russell Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008920 | Orphan claim re-pointed Claims processor | CLM-430836 → UHC-38799-01 (Santos Grace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008921 | Orphan claim re-pointed Claims processor | CLM-422487 → UHC-65746-05 (Tyler Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008922 | Orphan claim re-pointed Claims processor | CLM-426701 → UHC-42593-03 (Catherine Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008923 | Orphan claim re-pointed Claims processor | CLM-401032 → UHC-92382-34 (Kelly Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008924 | Orphan claim re-pointed Claims processor | CLM-407204 → UHC-81858-35 (Janet Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008925 | Orphan claim re-pointed Claims processor | CLM-417335 → UHC-24397-54 (Matthew Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008926 | Orphan claim re-pointed Claims processor | CLM-424684 → UHC-47674-88 (William Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008927 | Orphan claim re-pointed Claims processor | CLM-411087 → UHC-55156-14 (Lori Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008928 | Orphan claim re-pointed Claims processor | CLM-401260 → UHC-59285-16 (Nancy Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008929 | Orphan claim re-pointed Claims processor | CLM-416488 → UHC-71437-69 (Anthony Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008930 | Orphan claim re-pointed Claims processor | CLM-425887 → UHC-29311-43 (Nathan Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008931 | Orphan claim re-pointed Claims processor | CLM-416753 → UHC-79202-96 (Danielle Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008932 | Orphan claim re-pointed Claims processor | CLM-404728 → UHC-29195-03 (Jesse Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008933 | Orphan claim re-pointed Claims processor | CLM-431240 → UHC-98819-75 (Mariana Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008934 | Orphan claim re-pointed Claims processor | CLM-414036 → UHC-13671-78 (Christine Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008935 | Orphan claim re-pointed Claims processor | CLM-404410 → UHC-78331-45 (Matthew White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008936 | Orphan claim re-pointed Claims processor | CLM-407556 → UHC-58273-59 (Laura Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008937 | Orphan claim re-pointed Claims processor | CLM-407093 → UHC-76888-73 (Joseph Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008938 | Orphan claim re-pointed Claims processor | CLM-427498 → UHC-06392-96 (Yuki Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008939 | Orphan claim re-pointed Claims processor | CLM-425943 → UHC-85599-20 (Ralph Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008940 | Orphan claim re-pointed Claims processor | CLM-413475 → UHC-23662-24 (Stephen Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008941 | Orphan claim re-pointed Claims processor | CLM-411313 → UHC-37285-52 (Judy Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008942 | Orphan claim re-pointed Claims processor | CLM-431562 → UHC-34719-91 (Beverly George) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008943 | Orphan claim re-pointed Claims processor | CLM-428484 → UHC-55950-56 (Carol King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008944 | Orphan claim re-pointed Claims processor | CLM-403148 → UHC-23284-60 (Margaret James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008945 | Orphan claim re-pointed Claims processor | CLM-409558 → UHC-77073-62 (Diana Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008946 | Orphan claim re-pointed Claims processor | CLM-401051 → UHC-19364-47 (Rebecca Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008947 | Orphan claim re-pointed Claims processor | CLM-402017 → UHC-66052-13 (Raymond Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008948 | Orphan claim re-pointed Claims processor | CLM-414184 → UHC-84213-13 (Joseph Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008949 | Orphan claim re-pointed Claims processor | CLM-419122 → UHC-07841-77 (Jacob Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008950 | Orphan claim re-pointed Claims processor | CLM-413897 → UHC-71588-63 (Mason Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008951 | Orphan claim re-pointed Claims processor | CLM-428251 → UHC-77157-46 (Henry Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008952 | Orphan claim re-pointed Claims processor | CLM-414069 → UHC-38848-23 (Maria Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008953 | Orphan claim re-pointed Claims processor | CLM-420682 → UHC-43295-81 (Billy Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008954 | Orphan claim re-pointed Claims processor | CLM-424963 → UHC-66686-95 (Ahmed Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008955 | Orphan claim re-pointed Claims processor | CLM-419953 → UHC-11203-18 (Abigail Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008956 | Orphan claim re-pointed Claims processor | CLM-419423 → UHC-58223-62 (Joshua Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008957 | Orphan claim re-pointed Claims processor | CLM-427641 → UHC-57924-01 (Shirley Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008958 | Orphan claim re-pointed Claims processor | CLM-431846 → UHC-43497-04 (Ruth Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008959 | Orphan claim re-pointed Claims processor | CLM-407525 → UHC-71535-19 (Kelly Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008960 | Orphan claim re-pointed Claims processor | CLM-419450 → UHC-41138-39 (Willie Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-008961 | Orphan claim re-pointed Claims processor | CLM-407487 → UHC-58089-01 (Mason Ramirez) |
| 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.