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-009012 | Orphan claim re-pointed Claims processor | CLM-415258 → UHC-99761-49 (Keith Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009013 | Orphan claim re-pointed Claims processor | CLM-421049 → UHC-74848-26 (Jessica Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009014 | Orphan claim re-pointed Claims processor | CLM-431973 → UHC-27099-22 (Ethan Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009015 | Orphan claim re-pointed Claims processor | CLM-409208 → UHC-33869-68 (Jonathan Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009016 | Orphan claim re-pointed Claims processor | CLM-432677 → UHC-88110-90 (Rachel Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009017 | Orphan claim re-pointed Claims processor | CLM-419390 → UHC-59973-87 (Patrick Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009018 | Orphan claim re-pointed Claims processor | CLM-418912 → UHC-63669-97 (Natalie Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009019 | Orphan claim re-pointed Claims processor | CLM-420889 → UHC-50453-29 (Doris Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009020 | Orphan claim re-pointed Claims processor | CLM-415112 → UHC-29751-78 (Maria Motgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009021 | Orphan claim re-pointed Claims processor | CLM-420497 → UHC-40942-62 (Albert Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009022 | Orphan claim re-pointed Claims processor | CLM-428434 → UHC-23457-56 (Cheryl Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009023 | Orphan claim re-pointed Claims processor | CLM-400913 → UHC-81585-75 (Gloria Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009024 | Orphan claim re-pointed Claims processor | CLM-430605 → UHC-19967-99 (Patricia Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009025 | Orphan claim re-pointed Claims processor | CLM-430273 → UHC-76821-72 (Paul Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009026 | Orphan claim re-pointed Claims processor | CLM-422296 → UHC-94558-28 (Wei Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009027 | Orphan claim re-pointed Claims processor | CLM-406220 → UHC-50985-91 (Denise Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009028 | Orphan claim re-pointed Claims processor | CLM-423326 → UHC-58401-45 (Matthew Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009029 | Orphan claim re-pointed Claims processor | CLM-431831 → UHC-81705-80 (Maria Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009030 | Orphan claim re-pointed Claims processor | CLM-412985 → UHC-09672-15 (Katherine Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009031 | Orphan claim re-pointed Claims processor | CLM-417973 → UHC-59084-32 (Christian Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009032 | Orphan claim re-pointed Claims processor | CLM-403322 → UHC-76050-53 (Luis Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009033 | Orphan claim re-pointed Claims processor | CLM-401165 → UHC-93945-67 (Natalie Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009034 | Orphan claim re-pointed Claims processor | CLM-426471 → UHC-63347-73 (Deborah Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009035 | Orphan claim re-pointed Claims processor | CLM-427852 → UHC-63375-90 (Catherine Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009036 | Orphan claim re-pointed Claims processor | CLM-405044 → UHC-00623-94 (Kathleen Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009037 | Orphan claim re-pointed Claims processor | CLM-417220 → UHC-47337-39 (Gregory Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009038 | Orphan claim re-pointed Claims processor | CLM-407196 → UHC-35997-95 (Brandon Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009039 | Orphan claim re-pointed Claims processor | CLM-424663 → UHC-65482-05 (Kayla Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009040 | Orphan claim re-pointed Claims processor | CLM-400335 → UHC-82887-97 (Terry Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009041 | Orphan claim re-pointed Claims processor | CLM-423962 → UHC-36576-92 (Aisha Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009042 | Orphan claim re-pointed Claims processor | CLM-403785 → UHC-40507-82 (Timothy Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009043 | Orphan claim re-pointed Claims processor | CLM-411422 → UHC-50653-70 (Virginia Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009044 | Orphan claim re-pointed Claims processor | CLM-400833 → UHC-48716-78 (Gary Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009045 | Orphan claim re-pointed Claims processor | CLM-418927 → UHC-64407-76 (Aaron Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009046 | Orphan claim re-pointed Claims processor | CLM-406836 → UHC-57980-91 (Marilyn Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009047 | Orphan claim re-pointed Claims processor | CLM-416160 → UHC-20024-09 (Camila Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009048 | Orphan claim re-pointed Claims processor | CLM-431376 → UHC-52604-17 (Logan Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009049 | Orphan claim re-pointed Claims processor | CLM-417557 → UHC-46053-84 (Barbara Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009050 | Orphan claim re-pointed Claims processor | CLM-426963 → UHC-45605-61 (Maria Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009051 | Orphan claim re-pointed Claims processor | CLM-411209 → UHC-71144-96 (Eric Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009052 | Orphan claim re-pointed Claims processor | CLM-423865 → UHC-70077-98 (Danielle Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009053 | Orphan claim re-pointed Claims processor | CLM-418451 → UHC-00538-61 (Bradley Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009054 | Orphan claim re-pointed Claims processor | CLM-418272 → UHC-26269-59 (Shirley Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009055 | Orphan claim re-pointed Claims processor | CLM-427693 → UHC-54769-51 (Amy Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009056 | Orphan claim re-pointed Claims processor | CLM-417525 → UHC-52925-80 (Marilyn King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009057 | Orphan claim re-pointed Claims processor | CLM-401422 → UHC-90638-23 (Sandra Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009058 | Orphan claim re-pointed Claims processor | CLM-413157 → UHC-95210-09 (Zachary Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009059 | Orphan claim re-pointed Claims processor | CLM-421503 → UHC-47481-78 (Frank Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009060 | Orphan claim re-pointed Claims processor | CLM-411029 → UHC-46103-72 (Carolyn Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009061 | Orphan claim re-pointed Claims processor | CLM-401343 → UHC-03456-11 (Zachary Rodriguez) |
| 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.