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-009112 | Orphan claim re-pointed Claims processor | CLM-412206 → UHC-44341-11 (Kevin Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009113 | Orphan claim re-pointed Claims processor | CLM-400557 → UHC-74527-15 (Amy Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009114 | Orphan claim re-pointed Claims processor | CLM-413049 → UHC-10438-54 (Paul Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009115 | Orphan claim re-pointed Claims processor | CLM-426881 → UHC-38612-42 (Denise Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009116 | Orphan claim re-pointed Claims processor | CLM-428626 → UHC-63043-26 (Douglas Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009117 | Orphan claim re-pointed Claims processor | CLM-432179 → UHC-93868-90 (Amber Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009118 | Orphan claim re-pointed Claims processor | CLM-408516 → UHC-08518-76 (Larry Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009119 | Orphan claim re-pointed Claims processor | CLM-422015 → UHC-25799-28 (Sofia Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009120 | Orphan claim re-pointed Claims processor | CLM-425756 → UHC-62110-53 (Judith Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009121 | Orphan claim re-pointed Claims processor | CLM-422925 → UHC-25565-57 (Ahmed Murray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009122 | Orphan claim re-pointed Claims processor | CLM-425683 → UHC-66849-38 (Betty Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009123 | Orphan claim re-pointed Claims processor | CLM-402750 → UHC-72447-31 (Patrick Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009124 | Orphan claim re-pointed Claims processor | CLM-426760 → UHC-04410-23 (Beverly Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009125 | Orphan claim re-pointed Claims processor | CLM-429547 → UHC-36389-70 (Jacob Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009126 | Orphan claim re-pointed Claims processor | CLM-432544 → UHC-72757-38 (John Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009127 | Orphan claim re-pointed Claims processor | CLM-432108 → UHC-94590-96 (Andrew Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009128 | Orphan claim re-pointed Claims processor | CLM-413191 → UHC-98170-43 (Frank Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009129 | Orphan claim re-pointed Claims processor | CLM-426312 → UHC-28681-13 (Cheryl Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009130 | Orphan claim re-pointed Claims processor | CLM-407738 → UHC-83940-30 (Ronald Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009131 | Orphan claim re-pointed Claims processor | CLM-426233 → UHC-68851-64 (Russell Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009132 | Orphan claim re-pointed Claims processor | CLM-408963 → UHC-66151-99 (Gerald Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009133 | Orphan claim re-pointed Claims processor | CLM-413926 → UHC-18926-01 (Austin Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009134 | Orphan claim re-pointed Claims processor | CLM-424041 → UHC-51091-44 (Ruth Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009135 | Orphan claim re-pointed Claims processor | CLM-400993 → UHC-03797-09 (Matthew Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009136 | Orphan claim re-pointed Claims processor | CLM-406501 → UHC-30433-13 (Lawrence Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009137 | Orphan claim re-pointed Claims processor | CLM-430611 → UHC-26524-01 (Alan Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009138 | Orphan claim re-pointed Claims processor | CLM-417000 → UHC-38087-84 (Daniel Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009139 | Orphan claim re-pointed Claims processor | CLM-409850 → UHC-27113-70 (Scott Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009140 | Orphan claim re-pointed Claims processor | CLM-402501 → UHC-81063-83 (Lauren Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009141 | Orphan claim re-pointed Claims processor | CLM-401180 → UHC-89423-86 (Diego Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009142 | Orphan claim re-pointed Claims processor | CLM-425712 → UHC-99938-63 (Ronald Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009143 | Orphan claim re-pointed Claims processor | CLM-419572 → UHC-36595-86 (Eugene Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009144 | Orphan claim re-pointed Claims processor | CLM-404179 → UHC-51717-16 (Willie Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009145 | Orphan claim re-pointed Claims processor | CLM-417584 → UHC-05122-10 (Mateo Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009146 | Orphan claim re-pointed Claims processor | CLM-423056 → UHC-74392-69 (Ben Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009147 | Orphan claim re-pointed Claims processor | CLM-410460 → UHC-03711-37 (Zachary Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009148 | Orphan claim re-pointed Claims processor | CLM-429274 → UHC-64162-90 (Joyce Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009149 | Orphan claim re-pointed Claims processor | CLM-421505 → UHC-98726-28 (Donald Wite) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009150 | Orphan claim re-pointed Claims processor | CLM-426310 → UHC-51764-25 (Olivia Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009151 | Orphan claim re-pointed Claims processor | CLM-425826 → UHC-25328-51 (Ahmed Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009152 | Orphan claim re-pointed Claims processor | CLM-428079 → UHC-03389-40 (Cheryl Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009153 | Orphan claim re-pointed Claims processor | CLM-414867 → UHC-70103-18 (Jeremy Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009154 | Orphan claim re-pointed Claims processor | CLM-411543 → UHC-51126-87 (Jack Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009155 | Orphan claim re-pointed Claims processor | CLM-406414 → UHC-00910-34 (Anthony Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009156 | Orphan claim re-pointed Claims processor | CLM-427004 → UHC-89336-04 (Nathan Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009157 | Orphan claim re-pointed Claims processor | CLM-400620 → UHC-65560-71 (Gary Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009158 | Orphan claim re-pointed Claims processor | CLM-403919 → UHC-05862-91 (Zachary Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009159 | Orphan claim re-pointed Claims processor | CLM-431896 → UHC-00300-86 (Melissa Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009160 | Orphan claim re-pointed Claims processor | CLM-410121 → UHC-07328-18 (Dylan Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009161 | Orphan claim re-pointed Claims processor | CLM-419368 → UHC-56320-70 (Sean Nunez) |
| 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.