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-009662 | Orphan claim re-pointed Claims processor | CLM-432088 → UHC-15097-94 (Bruce Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009663 | Orphan claim re-pointed Claims processor | CLM-432092 → UHC-20902-13 (Samantha Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009664 | Orphan claim re-pointed Claims processor | CLM-413788 → UHC-01066-48 (Alice Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009665 | Orphan claim re-pointed Claims processor | CLM-417620 → UHC-21667-70 (Logan Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009666 | Orphan claim re-pointed Claims processor | CLM-411132 → UHC-39221-56 (Lori Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009667 | Orphan claim re-pointed Claims processor | CLM-429543 → UHC-90001-13 (Omar Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009668 | Orphan claim re-pointed Claims processor | CLM-413003 → UHC-54709-71 (Mateo Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009669 | Orphan claim re-pointed Claims processor | CLM-405133 → UHC-08142-79 (Richard Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009670 | Orphan claim re-pointed Claims processor | CLM-406631 → UHC-27982-32 (Lori Lane) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009671 | Orphan claim re-pointed Claims processor | CLM-424887 → UHC-92295-16 (Joyce Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009672 | Orphan claim re-pointed Claims processor | CLM-419046 → UHC-44964-27 (Peter Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009673 | Orphan claim re-pointed Claims processor | CLM-422180 → UHC-18366-77 (Evelyn Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009674 | Orphan claim re-pointed Claims processor | CLM-429609 → UHC-30744-33 (Elizabeth Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009675 | Orphan claim re-pointed Claims processor | CLM-416896 → UHC-68238-77 (Carol Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009676 | Orphan claim re-pointed Claims processor | CLM-403901 → UHC-83339-71 (Sofia Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009677 | Orphan claim re-pointed Claims processor | CLM-413551 → UHC-46841-03 (Rachel Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009678 | Orphan claim re-pointed Claims processor | CLM-406707 → UHC-78584-61 (Adams Frank) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009679 | Orphan claim re-pointed Claims processor | CLM-427703 → UHC-85622-08 (Jacqueline Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009680 | Orphan claim re-pointed Claims processor | CLM-420076 → UHC-29692-11 (Laura Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009681 | Orphan claim re-pointed Claims processor | CLM-424208 → UHC-53662-77 (Linda Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009682 | Orphan claim re-pointed Claims processor | CLM-432802 → UHC-67388-37 (Eugene Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009683 | Orphan claim re-pointed Claims processor | CLM-421463 → UHC-66715-60 (Denise Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009684 | Orphan claim re-pointed Claims processor | CLM-422229 → UHC-14730-39 (Gerald Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009685 | Orphan claim re-pointed Claims processor | CLM-412878 → UHC-62480-15 (Barbara Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009686 | Orphan claim re-pointed Claims processor | CLM-412152 → UHC-61614-87 (Sandra Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009687 | Orphan claim re-pointed Claims processor | CLM-404299 → UHC-66632-26 (Randy Snyder) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009688 | Orphan claim re-pointed Claims processor | CLM-415507 → UHC-27166-87 (Cheryl Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009689 | Orphan claim re-pointed Claims processor | CLM-406044 → UHC-05239-58 (Nicole Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009690 | Orphan claim re-pointed Claims processor | CLM-431775 → UHC-04842-26 (Dorothy Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009691 | Orphan claim re-pointed Claims processor | CLM-424691 → UHC-21980-71 (Julia Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009692 | Orphan claim re-pointed Claims processor | CLM-424998 → UHC-02366-75 (Thomas Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009693 | Orphan claim re-pointed Claims processor | CLM-427817 → UHC-77908-77 (Camila Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009694 | Orphan claim re-pointed Claims processor | CLM-414464 → UHC-13987-43 (Lucia Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009695 | Orphan claim re-pointed Claims processor | CLM-422402 → UHC-06772-04 (Sharon Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009696 | Orphan claim re-pointed Claims processor | CLM-425624 → UHC-56620-79 (Mason McDunald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009697 | Orphan claim re-pointed Claims processor | CLM-405318 → UHC-84944-11 (Danielle Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009698 | Orphan claim re-pointed Claims processor | CLM-404851 → UHC-96694-14 (Russell Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009699 | Orphan claim re-pointed Claims processor | CLM-400772 → UHC-08091-97 (Angela Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009700 | Orphan claim re-pointed Claims processor | CLM-414731 → UHC-18573-78 (Albert Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009701 | Orphan claim re-pointed Claims processor | CLM-418089 → UHC-72352-98 (Brian McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009702 | Orphan claim re-pointed Claims processor | CLM-409746 → UHC-75122-99 (Bruce Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009703 | Orphan claim re-pointed Claims processor | CLM-432498 → UHC-45875-06 (Kelly Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009704 | Orphan claim re-pointed Claims processor | CLM-416905 → UHC-90316-10 (Bobby Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009705 | Orphan claim re-pointed Claims processor | CLM-406869 → UHC-61614-40 (Virginia Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009706 | Orphan claim re-pointed Claims processor | CLM-418609 → UHC-43502-22 (Albert Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009707 | Orphan claim re-pointed Claims processor | CLM-412339 → UHC-25749-79 (Judy Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009708 | Orphan claim re-pointed Claims processor | CLM-415940 → UHC-99093-54 (Albert Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009709 | Orphan claim re-pointed Claims processor | CLM-404504 → UHC-39290-43 (Juan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009710 | Orphan claim re-pointed Claims processor | CLM-409588 → UHC-40919-31 (Donald Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009711 | Orphan claim re-pointed Claims processor | CLM-429866 → UHC-33407-76 (Carol Ruiz) |
| 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.