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-009312 | Orphan claim re-pointed Claims processor | CLM-423294 → UHC-86873-43 (Adam Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009313 | Orphan claim re-pointed Claims processor | CLM-425202 → UHC-01286-91 (Vincent Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009314 | Orphan claim re-pointed Claims processor | CLM-401815 → UHC-19141-31 (Theresa Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009315 | Orphan claim re-pointed Claims processor | CLM-426988 → UHC-99713-52 (Walter Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009316 | Orphan claim re-pointed Claims processor | CLM-430901 → UHC-76444-88 (Virginia Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009317 | Orphan claim re-pointed Claims processor | CLM-410250 → UHC-83567-23 (David Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009318 | Orphan claim re-pointed Claims processor | CLM-412214 → UHC-14032-93 (Dennis Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009319 | Orphan claim re-pointed Claims processor | CLM-425234 → UHC-84849-71 (David Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009320 | Orphan claim re-pointed Claims processor | CLM-415393 → UHC-35933-47 (Kathryn Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009321 | Orphan claim re-pointed Claims processor | CLM-414293 → UHC-05912-11 (Camila Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009322 | Orphan claim re-pointed Claims processor | CLM-420385 → UHC-24738-29 (Beverly Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009323 | Orphan claim re-pointed Claims processor | CLM-422462 → UHC-23637-74 (Scott Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009324 | Orphan claim re-pointed Claims processor | CLM-400805 → UHC-37944-44 (Steven Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009325 | Orphan claim re-pointed Claims processor | CLM-421845 → UHC-39649-87 (Zachaary Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009326 | Orphan claim re-pointed Claims processor | CLM-425919 → UHC-10286-63 (Stephanie Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009327 | Orphan claim re-pointed Claims processor | CLM-429416 → UHC-76690-56 (Douglas Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009328 | Orphan claim re-pointed Claims processor | CLM-431793 → UHC-26515-31 (Anthony Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009329 | Orphan claim re-pointed Claims processor | CLM-427890 → UHC-80821-83 (Emily Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009330 | Orphan claim re-pointed Claims processor | CLM-420636 → UHC-89527-97 (Jackie Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009331 | Orphan claim re-pointed Claims processor | CLM-411072 → UHC-35219-28 (Elizabeth Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009332 | Orphan claim re-pointed Claims processor | CLM-427998 → UHC-71867-23 (Shirley Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009333 | Orphan claim re-pointed Claims processor | CLM-422831 → UHC-24778-33 (Timothy Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009334 | Orphan claim re-pointed Claims processor | CLM-428463 → UHC-81512-01 (Betty Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009335 | Orphan claim re-pointed Claims processor | CLM-407455 → UHC-82007-66 (Jose Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009336 | Orphan claim re-pointed Claims processor | CLM-420584 → UHC-14069-21 (Gregory Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009337 | Orphan claim re-pointed Claims processor | CLM-408211 → UHC-31536-42 (Michael Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009338 | Orphan claim re-pointed Claims processor | CLM-410941 → UHC-46404-59 (Sarah Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009339 | Orphan claim re-pointed Claims processor | CLM-430182 → UHC-30928-47 (Keith Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009340 | Orphan claim re-pointed Claims processor | CLM-422749 → UHC-67292-12 (Julie Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009341 | Orphan claim re-pointed Claims processor | CLM-430012 → UHC-62291-99 (Larry Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009342 | Orphan claim re-pointed Claims processor | CLM-402421 → UHC-72475-98 (Lauren Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009343 | Orphan claim re-pointed Claims processor | CLM-422050 → UHC-03245-02 (Sharon Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009344 | Orphan claim re-pointed Claims processor | CLM-401772 → UHC-15533-67 (David Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009345 | Orphan claim re-pointed Claims processor | CLM-400305 → UHC-96259-40 (John Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009346 | Orphan claim re-pointed Claims processor | CLM-422113 → UHC-73625-05 (Gloria Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009347 | Orphan claim re-pointed Claims processor | CLM-426181 → UHC-01358-75 (Kevin Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009348 | Orphan claim re-pointed Claims processor | CLM-432132 → UHC-27136-95 (Logan Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009349 | Orphan claim re-pointed Claims processor | CLM-426933 → UHC-99283-82 (Michael Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009350 | Orphan claim re-pointed Claims processor | CLM-402855 → UHC-25785-59 (Logan James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009351 | Orphan claim re-pointed Claims processor | CLM-413944 → UHC-18925-10 (Margaret Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009352 | Orphan claim re-pointed Claims processor | CLM-407692 → UHC-87366-53 (Arthur Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009353 | Orphan claim re-pointed Claims processor | CLM-417125 → UHC-85213-42 (Jordan Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009354 | Orphan claim re-pointed Claims processor | CLM-418159 → UHC-29563-18 (Valentina Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009355 | Orphan claim re-pointed Claims processor | CLM-406590 → UHC-93344-27 (Mateo Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009356 | Orphan claim re-pointed Claims processor | CLM-423053 → UHC-92140-80 (Dennis Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009357 | Orphan claim re-pointed Claims processor | CLM-407247 → UHC-70367-18 (Grace Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009358 | Orphan claim re-pointed Claims processor | CLM-415613 → UHC-61579-57 (Beverly Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009359 | Orphan claim re-pointed Claims processor | CLM-407930 → UHC-02009-30 (Diego Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009360 | Orphan claim re-pointed Claims processor | CLM-414910 → UHC-52031-57 (Maria Warren) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009361 | Orphan claim re-pointed Claims processor | CLM-401357 → UHC-15221-74 (Jesse Kelly) |
| 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.