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-009262 | Orphan claim re-pointed Claims processor | CLM-417015 → UHC-08324-56 (Alice Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009263 | Orphan claim re-pointed Claims processor | CLM-424894 → UHC-23833-14 (Frank Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009264 | Orphan claim re-pointed Claims processor | CLM-411591 → UHC-44229-83 (Lawrence Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009265 | Orphan claim re-pointed Claims processor | CLM-428918 → UHC-62188-44 (Donald Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009266 | Orphan claim re-pointed Claims processor | CLM-425389 → UHC-87363-59 (Peter Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009267 | Orphan claim re-pointed Claims processor | CLM-411963 → UHC-08621-59 (Isabella Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009268 | Orphan claim re-pointed Claims processor | CLM-400560 → UHC-22304-73 (Mateo Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009269 | Orphan claim re-pointed Claims processor | CLM-423840 → UHC-65429-19 (Noah Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009270 | Orphan claim re-pointed Claims processor | CLM-429510 → UHC-70785-96 (Natalie Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009271 | Orphan claim re-pointed Claims processor | CLM-429874 → UHC-65196-52 (Lauren Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009272 | Orphan claim re-pointed Claims processor | CLM-426750 → UHC-02311-67 (Bradley Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009273 | Orphan claim re-pointed Claims processor | CLM-422111 → UHC-09967-78 (Emily Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009274 | Orphan claim re-pointed Claims processor | CLM-402018 → UHC-43714-69 (Dylan Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009275 | Orphan claim re-pointed Claims processor | CLM-428072 → UHC-98453-76 (Janice Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009276 | Orphan claim re-pointed Claims processor | CLM-432291 → UHC-70601-68 (Amber Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009277 | Orphan claim re-pointed Claims processor | CLM-410522 → UHC-44470-52 (Lucia Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009278 | Orphan claim re-pointed Claims processor | CLM-400531 → UHC-90545-25 (Helen Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009279 | Orphan claim re-pointed Claims processor | CLM-414197 → UHC-01209-57 (Kathryn Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009280 | Orphan claim re-pointed Claims processor | CLM-407032 → UHC-15519-28 (Joyce Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009281 | Orphan claim re-pointed Claims processor | CLM-408467 → UHC-70825-08 (Judy Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009282 | Orphan claim re-pointed Claims processor | CLM-404697 → UHC-76713-41 (Brenda Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009283 | Orphan claim re-pointed Claims processor | CLM-414441 → UHC-64017-72 (Evelyn Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009284 | Orphan claim re-pointed Claims processor | CLM-407410 → UHC-40634-02 (Cynthia Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009285 | Orphan claim re-pointed Claims processor | CLM-428980 → UHC-00004-76 (Carol Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009286 | Orphan claim re-pointed Claims processor | CLM-405124 → UHC-29366-06 (Jerry Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009287 | Orphan claim re-pointed Claims processor | CLM-421081 → UHC-68316-58 (Robert Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009288 | Orphan claim re-pointed Claims processor | CLM-404846 → UHC-96702-58 (Julie Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009289 | Orphan claim re-pointed Claims processor | CLM-409709 → UHC-56324-15 (Donna Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009290 | Orphan claim re-pointed Claims processor | CLM-422230 → UHC-03433-45 (Samuel Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009291 | Orphan claim re-pointed Claims processor | CLM-406729 → UHC-76046-66 (Jonathhan Owans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009292 | Orphan claim re-pointed Claims processor | CLM-415974 → UHC-40173-47 (Christina Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009293 | Orphan claim re-pointed Claims processor | CLM-407299 → UHC-53118-31 (Daniel Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009294 | Orphan claim re-pointed Claims processor | CLM-416118 → UHC-43006-53 (Frances Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009295 | Orphan claim re-pointed Claims processor | CLM-400236 → UHC-96990-15 (Angela Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009296 | Orphan claim re-pointed Claims processor | CLM-422154 → UHC-04832-19 (Douglas Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009297 | Orphan claim re-pointed Claims processor | CLM-416864 → UHC-27727-94 (Angela Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009298 | Orphan claim re-pointed Claims processor | CLM-419342 → UHC-94105-73 (Richard Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009299 | Orphan claim re-pointed Claims processor | CLM-423110 → UHC-12266-19 (Emily Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009300 | Orphan claim re-pointed Claims processor | CLM-413367 → UHC-50684-24 (Rachel Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009301 | Orphan claim re-pointed Claims processor | CLM-417797 → UHC-93719-60 (Justin Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009302 | Orphan claim re-pointed Claims processor | CLM-409603 → UHC-88185-60 (Ryan Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009303 | Orphan claim re-pointed Claims processor | CLM-406867 → UHC-61614-40 (Virginia Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009304 | Orphan claim re-pointed Claims processor | CLM-432583 → UHC-62488-93 (Mateo Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009305 | Orphan claim re-pointed Claims processor | CLM-414468 → UHC-46233-87 (William Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009306 | Orphan claim re-pointed Claims processor | CLM-402413 → UHC-40801-57 (Eugene Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009307 | Orphan claim re-pointed Claims processor | CLM-408281 → UHC-78528-57 (Betty Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009308 | Orphan claim re-pointed Claims processor | CLM-422982 → UHC-58276-63 (Omar Schultz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009309 | Orphan claim re-pointed Claims processor | CLM-417844 → UHC-68577-83 (Walter Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009310 | Orphan claim re-pointed Claims processor | CLM-413947 → UHC-34110-11 (Mason Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009311 | Orphan claim re-pointed Claims processor | CLM-432523 → UHC-05149-71 (Brandon Graham) |
| 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.