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-009362 | Orphan claim re-pointed Claims processor | CLM-407933 → UHC-72108-02 (Cynthia Lucas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009363 | Orphan claim re-pointed Claims processor | CLM-413756 → UHC-36242-97 (Cheryl Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009364 | Orphan claim re-pointed Claims processor | CLM-405691 → UHC-87845-70 (Santiago Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009365 | Orphan claim re-pointed Claims processor | CLM-421675 → UHC-81905-48 (Justin Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009366 | Orphan claim re-pointed Claims processor | CLM-424993 → UHC-79322-77 (Samuel Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009367 | Orphan claim re-pointed Claims processor | CLM-432409 → UHC-65037-61 (Jessica Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009368 | Orphan claim re-pointed Claims processor | CLM-426841 → UHC-88130-93 (Danielle Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009369 | Orphan claim re-pointed Claims processor | CLM-431825 → UHC-65217-11 (Charles Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009370 | Orphan claim re-pointed Claims processor | CLM-401230 → UHC-81424-76 (Yuki Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009371 | Orphan claim re-pointed Claims processor | CLM-411515 → UHC-90578-64 (Carl McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009372 | Orphan claim re-pointed Claims processor | CLM-410422 → UHC-25604-98 (Ethan Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009373 | Orphan claim re-pointed Claims processor | CLM-432775 → UHC-11018-53 (Mason Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009374 | Orphan claim re-pointed Claims processor | CLM-432571 → UHC-58693-80 (Jeremy Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009375 | Orphan claim re-pointed Claims processor | CLM-424494 → UHC-68274-91 (Ryan Ramirez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009376 | Orphan claim re-pointed Claims processor | CLM-427262 → UHC-26724-61 (John Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009377 | Orphan claim re-pointed Claims processor | CLM-424497 → UHC-20697-04 (Carol Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009378 | Orphan claim re-pointed Claims processor | CLM-415557 → UHC-32635-41 (Roy Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009379 | Orphan claim re-pointed Claims processor | CLM-402398 → UHC-65211-83 (Beth Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009380 | Orphan claim re-pointed Claims processor | CLM-413740 → UHC-51134-40 (Bryan Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009381 | Orphan claim re-pointed Claims processor | CLM-401748 → UHC-94405-06 (James Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009382 | Orphan claim re-pointed Claims processor | CLM-409175 → UHC-93786-89 (Barbara Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009383 | Orphan claim re-pointed Claims processor | CLM-424629 → UHC-46867-34 (Ann Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009384 | Orphan claim re-pointed Claims processor | CLM-411907 → UHC-49757-35 (Jonathan Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009385 | Orphan claim re-pointed Claims processor | CLM-412007 → UHC-57532-94 (Julia Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009386 | Orphan claim re-pointed Claims processor | CLM-428502 → UHC-44964-12 (Kimberly Howard) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009387 | Orphan claim re-pointed Claims processor | CLM-405479 → UHC-62597-73 (Mei Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009388 | Orphan claim re-pointed Claims processor | CLM-402009 → UHC-28147-69 (Julia Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009389 | Orphan claim re-pointed Claims processor | CLM-420538 → UHC-55090-52 (Marcus Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009390 | Orphan claim re-pointed Claims processor | CLM-431619 → UHC-61305-53 (Evelyn Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009391 | Orphan claim re-pointed Claims processor | CLM-407656 → UHC-72721-98 (Rebecca Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009392 | Orphan claim re-pointed Claims processor | CLM-421433 → UHC-68694-09 (Martha Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009393 | Orphan claim re-pointed Claims processor | CLM-400543 → UHC-49030-70 (Bryan Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009394 | Orphan claim re-pointed Claims processor | CLM-414762 → UHC-19964-84 (Sofia Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009395 | Orphan claim re-pointed Claims processor | CLM-403049 → UHC-36033-31 (Ethan Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009396 | Orphan claim re-pointed Claims processor | CLM-420350 → UHC-67550-86 (Helen Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009397 | Orphan claim re-pointed Claims processor | CLM-404831 → UHC-59481-37 (Laura Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009398 | Orphan claim re-pointed Claims processor | CLM-420164 → UHC-90658-11 (Christine Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009399 | Orphan claim re-pointed Claims processor | CLM-403147 → UHC-23284-60 (Margaret James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009400 | Orphan claim re-pointed Claims processor | CLM-407515 → UHC-97544-20 (Lawrence Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009401 | Orphan claim re-pointed Claims processor | CLM-407305 → UHC-91879-89 (Judith Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009402 | Orphan claim re-pointed Claims processor | CLM-401325 → UHC-20084-25 (Logan Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009403 | Orphan claim re-pointed Claims processor | CLM-420780 → UHC-15397-39 (Benjamin Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009404 | Orphan claim re-pointed Claims processor | CLM-409545 → UHC-27048-49 (Angela Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009405 | Orphan claim re-pointed Claims processor | CLM-411700 → UHC-58436-86 (Mateo King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009406 | Orphan claim re-pointed Claims processor | CLM-404951 → UHC-57723-01 (Logan Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009407 | Orphan claim re-pointed Claims processor | CLM-417948 → UHC-11656-07 (Judy Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009408 | Orphan claim re-pointed Claims processor | CLM-400561 → UHC-02160-38 (Madison Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009409 | Orphan claim re-pointed Claims processor | CLM-425614 → UHC-76572-73 (Bryn Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009410 | Orphan claim re-pointed Claims processor | CLM-408453 → UHC-89838-16 (Lawrence Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009411 | Orphan claim re-pointed Claims processor | CLM-425524 → UHC-06856-30 (Cynthia Santiago) |
| 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.