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-009562 | Orphan claim re-pointed Claims processor | CLM-415696 → UHC-13174-98 (Judy Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009563 | Orphan claim re-pointed Claims processor | CLM-430298 → UHC-61149-15 (Alexander Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009564 | Orphan claim re-pointed Claims processor | CLM-429430 → UHC-40897-12 (Dorothy Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009565 | Orphan claim re-pointed Claims processor | CLM-409083 → UHC-61419-84 (Kathryn Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009566 | Orphan claim re-pointed Claims processor | CLM-407940 → UHC-60762-21 (Donald Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009567 | Orphan claim re-pointed Claims processor | CLM-408812 → UHC-12996-17 (Mary Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009568 | Orphan claim re-pointed Claims processor | CLM-422379 → UHC-45736-97 (David Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009569 | Orphan claim re-pointed Claims processor | CLM-402232 → UHC-11287-52 (Stephanie Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009570 | Orphan claim re-pointed Claims processor | CLM-426634 → UHC-62320-38 (Barbara Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009571 | Orphan claim re-pointed Claims processor | CLM-431165 → UHC-21829-60 (Rachel Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009572 | Orphan claim re-pointed Claims processor | CLM-423935 → UHC-37895-83 (Kenneth Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009573 | Orphan claim re-pointed Claims processor | CLM-409683 → UHC-58749-30 (Alice Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009574 | Orphan claim re-pointed Claims processor | CLM-406514 → UHC-58654-72 (Virginia Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009575 | Orphan claim re-pointed Claims processor | CLM-414254 → UHC-23742-38 (Brittany Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009576 | Orphan claim re-pointed Claims processor | CLM-414509 → UHC-70261-24 (Samuel Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009577 | Orphan claim re-pointed Claims processor | CLM-420557 → UHC-21260-01 (Natalie Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009578 | Orphan claim re-pointed Claims processor | CLM-402348 → UHC-68685-92 (Mary Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009579 | Orphan claim re-pointed Claims processor | CLM-431419 → UHC-90045-65 (Joan Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009580 | Orphan claim re-pointed Claims processor | CLM-418988 → UHC-44369-43 (Sophia Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009581 | Orphan claim re-pointed Claims processor | CLM-412064 → UHC-55338-16 (Kathryn Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009582 | Orphan claim re-pointed Claims processor | CLM-405026 → UHC-16902-14 (Christine Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009583 | Orphan claim re-pointed Claims processor | CLM-411262 → UHC-28602-56 (Adam Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009584 | Orphan claim re-pointed Claims processor | CLM-425274 → UHC-27517-35 (Randy Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009585 | Orphan claim re-pointed Claims processor | CLM-419031 → UHC-09498-69 (Stephanie Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009586 | Orphan claim re-pointed Claims processor | CLM-422483 → UHC-65025-01 (Bobby Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009587 | Orphan claim re-pointed Claims processor | CLM-418441 → UHC-18764-68 (Harrold Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009588 | Orphan claim re-pointed Claims processor | CLM-402766 → UHC-54330-79 (Lori Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009589 | Orphan claim re-pointed Claims processor | CLM-420100 → UHC-20965-16 (Dorothy Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009590 | Orphan claim re-pointed Claims processor | CLM-422998 → UHC-92316-19 (Patricia Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009591 | Orphan claim re-pointed Claims processor | CLM-414395 → UHC-42867-23 (Vincent Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009592 | Orphan claim re-pointed Claims processor | CLM-410603 → UHC-24627-62 (Janet Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009593 | Orphan claim re-pointed Claims processor | CLM-410187 → UHC-43293-68 (Kyle Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009594 | Orphan claim re-pointed Claims processor | CLM-413451 → UHC-10855-85 (Samantha Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009595 | Orphan claim re-pointed Claims processor | CLM-425662 → UHC-15001-22 (Benjamin Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009596 | Orphan claim re-pointed Claims processor | CLM-422089 → UHC-67772-21 (Aisha Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009597 | Orphan claim re-pointed Claims processor | CLM-423268 → UHC-79108-37 (Stephen Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009598 | Orphan claim re-pointed Claims processor | CLM-410889 → UHC-91757-89 (Katherine Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009599 | Orphan claim re-pointed Claims processor | CLM-417654 → UHC-89409-50 (Roy Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009600 | Orphan claim re-pointed Claims processor | CLM-406736 → UHC-53310-24 (Christian Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009601 | Orphan claim re-pointed Claims processor | CLM-431356 → UHC-83163-59 (Elizabeth Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009602 | Orphan claim re-pointed Claims processor | CLM-414968 → UHC-50709-36 (Henry Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009603 | Orphan claim re-pointed Claims processor | CLM-421176 → UHC-73240-85 (Willie Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009604 | Orphan claim re-pointed Claims processor | CLM-430604 → UHC-82354-43 (Elizabeth Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009605 | Orphan claim re-pointed Claims processor | CLM-423946 → UHC-49852-21 (Sandra Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009606 | Orphan claim re-pointed Claims processor | CLM-427660 → UHC-38301-28 (Mason Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009607 | Orphan claim re-pointed Claims processor | CLM-404508 → UHC-98038-11 (Eugene Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009608 | Orphan claim re-pointed Claims processor | CLM-408563 → UHC-76825-64 (Carol Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009609 | Orphan claim re-pointed Claims processor | CLM-400247 → UHC-08559-01 (Jonathan Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009610 | Orphan claim re-pointed Claims processor | CLM-428113 → UHC-75946-86 (Janice Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009611 | Orphan claim re-pointed Claims processor | CLM-421348 → UHC-21833-47 (Michelle Cooper) |
| 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.