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-009462 | Orphan claim re-pointed Claims processor | CLM-411379 → UHC-58441-16 (Stephen Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009463 | Orphan claim re-pointed Claims processor | CLM-405793 → UHC-68970-84 (Walter Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009464 | Orphan claim re-pointed Claims processor | CLM-406100 → UHC-28520-62 (Evelyn Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009465 | Orphan claim re-pointed Claims processor | CLM-402987 → UHC-59025-32 (Carolyn Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009466 | Orphan claim re-pointed Claims processor | CLM-421169 → UHC-14105-31 (Priya Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009467 | Orphan claim re-pointed Claims processor | CLM-422450 → UHC-91224-18 (Dylan Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009468 | Orphan claim re-pointed Claims processor | CLM-400317 → UHC-13066-46 (Keith Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009469 | Orphan claim re-pointed Claims processor | CLM-421584 → UHC-06869-63 (Helen Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009470 | Orphan claim re-pointed Claims processor | CLM-427280 → UHC-29797-34 (George Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009471 | Orphan claim re-pointed Claims processor | CLM-432584 → UHC-64454-23 (Alan Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009472 | Orphan claim re-pointed Claims processor | CLM-413471 → UHC-80735-98 (Jonathan Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009473 | Orphan claim re-pointed Claims processor | CLM-431537 → UHC-98440-07 (Amanda Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009474 | Orphan claim re-pointed Claims processor | CLM-426821 → UHC-98034-10 (Rebecca Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009475 | Orphan claim re-pointed Claims processor | CLM-401499 → UHC-64428-98 (Judith Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009476 | Orphan claim re-pointed Claims processor | CLM-412043 → UHC-18362-92 (Scott Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009477 | Orphan claim re-pointed Claims processor | CLM-424078 → UHC-85847-31 (Hannah Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009478 | Orphan claim re-pointed Claims processor | CLM-424907 → UHC-29007-63 (Diego Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009479 | Orphan claim re-pointed Claims processor | CLM-405043 → UHC-21653-62 (Matthew Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009480 | Orphan claim re-pointed Claims processor | CLM-421751 → UHC-28565-63 (Dylan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009481 | Orphan claim re-pointed Claims processor | CLM-407668 → UHC-95333-52 (Kevin Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009482 | Orphan claim re-pointed Claims processor | CLM-412523 → UHC-58414-02 (Lawrence Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009483 | Orphan claim re-pointed Claims processor | CLM-408908 → UHC-88067-96 (Jose Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009484 | Orphan claim re-pointed Claims processor | CLM-429329 → UHC-56998-94 (Bryan Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009485 | Orphan claim re-pointed Claims processor | CLM-416098 → UHC-85770-80 (Jeremy Aguilar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009486 | Orphan claim re-pointed Claims processor | CLM-412507 → UHC-05448-55 (Virginia Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009487 | Orphan claim re-pointed Claims processor | CLM-415736 → UHC-78951-31 (Brian Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009488 | Orphan claim re-pointed Claims processor | CLM-428464 → UHC-52947-73 (Megan Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009489 | Orphan claim re-pointed Claims processor | CLM-419442 → UHC-78243-99 (Brenda Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009490 | Orphan claim re-pointed Claims processor | CLM-409900 → UHC-09453-25 (Martha Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009491 | Orphan claim re-pointed Claims processor | CLM-425481 → UHC-32707-31 (Patrick Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009492 | Orphan claim re-pointed Claims processor | CLM-407823 → UHC-17323-63 (Wayne Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009493 | Orphan claim re-pointed Claims processor | CLM-411968 → UHC-35000-43 (Brian Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009494 | Orphan claim re-pointed Claims processor | CLM-400639 → UHC-24189-14 (Russell Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009495 | Orphan claim re-pointed Claims processor | CLM-423827 → UHC-33667-52 (Andrea Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009496 | Orphan claim re-pointed Claims processor | CLM-406520 → UHC-72768-33 (Melissa Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009497 | Orphan claim re-pointed Claims processor | CLM-419852 → UHC-64421-02 (Mason Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009498 | Orphan claim re-pointed Claims processor | CLM-413545 → UHC-69020-57 (Kelly Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009499 | Orphan claim re-pointed Claims processor | CLM-414321 → UHC-24555-87 (Angela Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009500 | Orphan claim re-pointed Claims processor | CLM-415184 → UHC-95783-42 (Lida Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009501 | Orphan claim re-pointed Claims processor | CLM-415921 → UHC-68630-22 (Donna Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009502 | Orphan claim re-pointed Claims processor | CLM-417577 → UHC-96995-64 (Angela Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009503 | Orphan claim re-pointed Claims processor | CLM-400731 → UHC-76291-34 (Jacob Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009504 | Orphan claim re-pointed Claims processor | CLM-400624 → UHC-22020-09 (Harold Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009505 | Orphan claim re-pointed Claims processor | CLM-431899 → UHC-38371-52 (Margaret Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009506 | Orphan claim re-pointed Claims processor | CLM-426935 → UHC-69569-85 (Ashley Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009507 | Orphan claim re-pointed Claims processor | CLM-415415 → UHC-84537-40 (Carolyn Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009508 | Orphan claim re-pointed Claims processor | CLM-422353 → UHC-58969-79 (Marcus Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009509 | Orphan claim re-pointed Claims processor | CLM-423898 → UHC-11485-33 (Mateo Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009510 | Orphan claim re-pointed Claims processor | CLM-419586 → UHC-89576-14 (Karen Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009511 | Orphan claim re-pointed Claims processor | CLM-416802 → UHC-33270-80 (Michelle Reed) |
| 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.