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-009162 | Orphan claim re-pointed Claims processor | CLM-421653 → UHC-48927-65 (James Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009163 | Orphan claim re-pointed Claims processor | CLM-409302 → UHC-53249-64 (Nataliie Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009164 | Orphan claim re-pointed Claims processor | CLM-430874 → UHC-99631-53 (Stephen Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009165 | Orphan claim re-pointed Claims processor | CLM-419521 → UHC-85777-05 (Peter Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009166 | Orphan claim re-pointed Claims processor | CLM-424577 → UHC-88200-35 (Kelly Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009167 | Orphan claim re-pointed Claims processor | CLM-420406 → UHC-26372-60 (Sara Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009168 | Orphan claim re-pointed Claims processor | CLM-407921 → UHC-31162-50 (Randy Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009169 | Orphan claim re-pointed Claims processor | CLM-413440 → UHC-63823-65 (Bruce Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009170 | Orphan claim re-pointed Claims processor | CLM-406508 → UHC-92335-51 (Jordan Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009171 | Orphan claim re-pointed Claims processor | CLM-410569 → UHC-43471-66 (Marilyn Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009172 | Orphan claim re-pointed Claims processor | CLM-419654 → UHC-03351-44 (Lisa Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009173 | Orphan claim re-pointed Claims processor | CLM-406422 → UHC-16872-58 (Stephanie Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009174 | Orphan claim re-pointed Claims processor | CLM-405116 → UHC-51047-78 (Jesse Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009175 | Orphan claim re-pointed Claims processor | CLM-405707 → UHC-61535-22 (Arjun Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009176 | Orphan claim re-pointed Claims processor | CLM-409067 → UHC-60107-66 (Stephen Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009177 | Orphan claim re-pointed Claims processor | CLM-420964 → UHC-35949-93 (Arthur Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009178 | Orphan claim re-pointed Claims processor | CLM-428905 → UHC-05355-82 (Joyce Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009179 | Orphan claim re-pointed Claims processor | CLM-401360 → UHC-95131-79 (Barbara Taylor) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009180 | Orphan claim re-pointed Claims processor | CLM-406775 → UHC-24250-02 (Carl Owens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009181 | Orphan claim re-pointed Claims processor | CLM-408204 → UHC-17925-71 (Sarah Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009182 | Orphan claim re-pointed Claims processor | CLM-418351 → UHC-74847-84 (Bobby Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009183 | Orphan claim re-pointed Claims processor | CLM-402965 → UHC-44414-07 (Julie Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009184 | Orphan claim re-pointed Claims processor | CLM-431158 → UHC-90196-95 (Ethan Thompson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009185 | Orphan claim re-pointed Claims processor | CLM-426309 → UHC-51764-25 (Olivia Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009186 | Orphan claim re-pointed Claims processor | CLM-400892 → UHC-11140-30 (Amber Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009187 | Orphan claim re-pointed Claims processor | CLM-415568 → UHC-04897-53 (Benjamin Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009188 | Orphan claim re-pointed Claims processor | CLM-408893 → UHC-65157-91 (Jean Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009189 | Orphan claim re-pointed Claims processor | CLM-425739 → UHC-85052-29 (Luis Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009190 | Orphan claim re-pointed Claims processor | CLM-428707 → UHC-38582-59 (Charlotte Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009191 | Orphan claim re-pointed Claims processor | CLM-400272 → UHC-25022-82 (Kenneth Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009192 | Orphan claim re-pointed Claims processor | CLM-403911 → UHC-70525-73 (Donna Griffin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009193 | Orphan claim re-pointed Claims processor | CLM-411674 → UHC-39682-17 (Grace Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009194 | Orphan claim re-pointed Claims processor | CLM-427565 → UHC-11526-69 (Brian Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009195 | Orphan claim re-pointed Claims processor | CLM-424753 → UHC-13868-34 (Harold Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009196 | Orphan claim re-pointed Claims processor | CLM-428297 → UHC-99707-65 (Michael Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009197 | Orphan claim re-pointed Claims processor | CLM-417227 → UHC-45726-10 (Jordan Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009198 | Orphan claim re-pointed Claims processor | CLM-417011 → UHC-16577-28 (Justin Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009199 | Orphan claim re-pointed Claims processor | CLM-401341 → UHC-05992-19 (Catherine Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009200 | Orphan claim re-pointed Claims processor | CLM-409823 → UHC-93802-82 (Frances Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009201 | Orphan claim re-pointed Claims processor | CLM-427074 → UHC-77787-12 (Deborah Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009202 | Orphan claim re-pointed Claims processor | CLM-432337 → UHC-80730-48 (Richard Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009203 | Orphan claim re-pointed Claims processor | CLM-430458 → UHC-50436-75 (Benjamin Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009204 | Orphan claim re-pointed Claims processor | CLM-424711 → UHC-07807-62 (Dylan Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009205 | Orphan claim re-pointed Claims processor | CLM-421577 → UHC-75772-33 (Michael Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009206 | Orphan claim re-pointed Claims processor | CLM-404505 → UHC-39290-43 (Juan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009207 | Orphan claim re-pointed Claims processor | CLM-403337 → UHC-80513-60 (Liz Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009208 | Orphan claim re-pointed Claims processor | CLM-415745 → UHC-82208-74 (Nancy Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009209 | Orphan claim re-pointed Claims processor | CLM-428647 → UHC-42607-41 (Kathy Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009210 | Orphan claim re-pointed Claims processor | CLM-406445 → UHC-43328-08 (Abby Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009211 | Orphan claim re-pointed Claims processor | CLM-408801 → UHC-04306-87 (Theresa Wheeler) |
| 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.