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-009212 | Orphan claim re-pointed Claims processor | CLM-419850 → UHC-79133-62 (Eric McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009213 | Orphan claim re-pointed Claims processor | CLM-420828 → UHC-87262-31 (Paul Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009214 | Orphan claim re-pointed Claims processor | CLM-424873 → UHC-21910-53 (Alice Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009215 | Orphan claim re-pointed Claims processor | CLM-426958 → UHC-18445-56 (Joan Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009216 | Orphan claim re-pointed Claims processor | CLM-418789 → UHC-75126-91 (Bryan Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009217 | Orphan claim re-pointed Claims processor | CLM-413822 → UHC-28890-43 (Madison Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009218 | Orphan claim re-pointed Claims processor | CLM-413715 → UHC-92115-37 (Denise Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009219 | Orphan claim re-pointed Claims processor | CLM-408773 → UHC-76784-79 (Joyce Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009220 | Orphan claim re-pointed Claims processor | CLM-427634 → UHC-19542-78 (Justin Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009221 | Orphan claim re-pointed Claims processor | CLM-401348 → UHC-92157-55 (Justin Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009222 | Orphan claim re-pointed Claims processor | CLM-417667 → UHC-39147-21 (Samantha Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009223 | Orphan claim re-pointed Claims processor | CLM-422753 → UHC-93830-13 (Julie Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009224 | Orphan claim re-pointed Claims processor | CLM-423712 → UHC-37491-91 (Ashley Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009225 | Orphan claim re-pointed Claims processor | CLM-407189 → UHC-52970-96 (Linda Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009226 | Orphan claim re-pointed Claims processor | CLM-407762 → UHC-37982-54 (Priya Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009227 | Orphan claim re-pointed Claims processor | CLM-419801 → UHC-19446-14 (Diane Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009228 | Orphan claim re-pointed Claims processor | CLM-400016 → UHC-39574-66 (Margaret Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009229 | Orphan claim re-pointed Claims processor | CLM-403552 → UHC-39760-46 (Carolyn Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009230 | Orphan claim re-pointed Claims processor | CLM-406527 → UHC-97135-95 (Charlotte Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009231 | Orphan claim re-pointed Claims processor | CLM-432099 → UHC-21397-33 (Rachel Vazuez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009232 | Orphan claim re-pointed Claims processor | CLM-406604 → UHC-65800-71 (Ray Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009233 | Orphan claim re-pointed Claims processor | CLM-428807 → UHC-98736-64 (Douglas Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009234 | Orphan claim re-pointed Claims processor | CLM-401222 → UHC-28284-55 (Julie Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009235 | Orphan claim re-pointed Claims processor | CLM-410407 → UHC-33225-10 (Chris James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009236 | Orphan claim re-pointed Claims processor | CLM-425091 → UHC-38982-72 (Grace Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009237 | Orphan claim re-pointed Claims processor | CLM-424011 → UHC-97185-04 (Marcus Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009238 | Orphan claim re-pointed Claims processor | CLM-402839 → UHC-18090-11 (Janet Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009239 | Orphan claim re-pointed Claims processor | CLM-414462 → UHC-55392-40 (Linda Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009240 | Orphan claim re-pointed Claims processor | CLM-421741 → UHC-22202-45 (Ntaalie Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009241 | Orphan claim re-pointed Claims processor | CLM-429085 → UHC-50742-28 (Thomas Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009242 | Orphan claim re-pointed Claims processor | CLM-415094 → UHC-88221-68 (Abigail Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009243 | Orphan claim re-pointed Claims processor | CLM-420016 → UHC-07607-29 (Mark Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009244 | Orphan claim re-pointed Claims processor | CLM-413668 → UHC-79675-66 (Stephen Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009245 | Orphan claim re-pointed Claims processor | CLM-413128 → UHC-32395-41 (Randy Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009246 | Orphan claim re-pointed Claims processor | CLM-432423 → UHC-69967-07 (Kayla Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009247 | Orphan claim re-pointed Claims processor | CLM-424997 → UHC-37104-79 (Ralph Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009248 | Orphan claim re-pointed Claims processor | CLM-425796 → UHC-12027-17 (Debra Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009249 | Orphan claim re-pointed Claims processor | CLM-407391 → UHC-07589-19 (Dylan Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009250 | Orphan claim re-pointed Claims processor | CLM-418733 → UHC-67061-31 (Lauren Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009251 | Orphan claim re-pointed Claims processor | CLM-405916 → UHC-82374-33 (Beverly Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009252 | Orphan claim re-pointed Claims processor | CLM-412731 → UHC-50637-70 (Maria Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009253 | Orphan claim re-pointed Claims processor | CLM-400948 → UHC-55811-29 (Heather Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009254 | Orphan claim re-pointed Claims processor | CLM-421942 → UHC-12863-64 (Ryan Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009255 | Orphan claim re-pointed Claims processor | CLM-432312 → UHC-35129-23 (Ashley Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009256 | Orphan claim re-pointed Claims processor | CLM-431388 → UHC-15907-37 (Wayne Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009257 | Orphan claim re-pointed Claims processor | CLM-408017 → UHC-66895-93 (Beverly Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009258 | Orphan claim re-pointed Claims processor | CLM-430230 → UHC-73684-45 (Maria Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009259 | Orphan claim re-pointed Claims processor | CLM-403469 → UHC-86169-56 (Anthony Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009260 | Orphan claim re-pointed Claims processor | CLM-402354 → UHC-24589-90 (Angela Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009261 | Orphan claim re-pointed Claims processor | CLM-405125 → UHC-37873-37 (Carol Fisher) |
| 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.