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-009712 | Orphan claim re-pointed Claims processor | CLM-401344 → UHC-85563-72 (Sara Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009713 | Orphan claim re-pointed Claims processor | CLM-405906 → UHC-84386-45 (Gregory Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009714 | Orphan claim re-pointed Claims processor | CLM-409927 → UHC-52699-22 (Brittany Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009715 | Orphan claim re-pointed Claims processor | CLM-421974 → UHC-16147-23 (Kyle Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009716 | Orphan claim re-pointed Claims processor | CLM-432280 → UHC-24206-61 (Amanda Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009717 | Orphan claim re-pointed Claims processor | CLM-401908 → UHC-29088-65 (Walter Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009718 | Orphan claim re-pointed Claims processor | CLM-423069 → UHC-99771-23 (Nathan Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009719 | Orphan claim re-pointed Claims processor | CLM-408566 → UHC-53874-23 (Janet Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009720 | Orphan claim re-pointed Claims processor | CLM-422047 → UHC-89227-34 (Carlos Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009721 | Orphan claim re-pointed Claims processor | CLM-414756 → UHC-87599-06 (Sandra Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009722 | Orphan claim re-pointed Claims processor | CLM-420706 → UHC-73110-21 (Peter Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009723 | Orphan claim re-pointed Claims processor | CLM-419558 → UHC-69511-69 (Rachel Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009724 | Orphan claim re-pointed Claims processor | CLM-405002 → UHC-32929-28 (Julia Meyer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009725 | Orphan claim re-pointed Claims processor | CLM-415919 → UHC-84155-80 (Karen Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009726 | Orphan claim re-pointed Claims processor | CLM-413237 → UHC-46471-24 (Ahmed Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009727 | Orphan claim re-pointed Claims processor | CLM-404240 → UHC-86120-37 (Martha Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009728 | Orphan claim re-pointed Claims processor | CLM-425353 → UHC-18597-75 (Isabella Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009729 | Orphan claim re-pointed Claims processor | CLM-402437 → UHC-55403-36 (Denise Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009730 | Orphan claim re-pointed Claims processor | CLM-416223 → UHC-93006-69 (Donna Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009731 | Orphan claim re-pointed Claims processor | CLM-416699 → UHC-75227-62 (Luis Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009732 | Orphan claim re-pointed Claims processor | CLM-404918 → UHC-88136-88 (Cheryl Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009733 | Orphan claim re-pointed Claims processor | CLM-427977 → UHC-19292-41 (Ruth Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009734 | Orphan claim re-pointed Claims processor | CLM-420218 → UHC-39537-44 (Logan Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009735 | Orphan claim re-pointed Claims processor | CLM-406097 → UHC-55420-11 (Alan Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009736 | Orphan claim re-pointed Claims processor | CLM-405223 → UHC-28414-39 (Lsa Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009737 | Orphan claim re-pointed Claims processor | CLM-406879 → UHC-12515-95 (Ana Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009738 | Orphan claim re-pointed Claims processor | CLM-405232 → UHC-52836-55 (Victoria Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009739 | Orphan claim re-pointed Claims processor | CLM-411641 → UHC-09388-80 (Jason Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009740 | Orphan claim re-pointed Claims processor | CLM-429761 → UHC-97923-15 (Nicole Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009741 | Orphan claim re-pointed Claims processor | CLM-408741 → UHC-63134-98 (Alice Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009742 | Orphan claim re-pointed Claims processor | CLM-429299 → UHC-18016-81 (Arthur Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009743 | Orphan claim re-pointed Claims processor | CLM-418670 → UHC-78816-20 (Jack Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009744 | Orphan claim re-pointed Claims processor | CLM-420645 → UHC-29663-24 (Adam Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009745 | Orphan claim re-pointed Claims processor | CLM-428397 → UHC-47295-78 (Paul Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009746 | Orphan claim re-pointed Claims processor | CLM-408181 → UHC-19783-63 (Alice Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009747 | Orphan claim re-pointed Claims processor | CLM-411092 → UHC-82957-73 (Luis Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009748 | Orphan claim re-pointed Claims processor | CLM-411562 → UHC-96174-01 (Valentina Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009749 | Orphan claim re-pointed Claims processor | CLM-415104 → UHC-98397-43 (Ralph Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009750 | Orphan claim re-pointed Claims processor | CLM-429016 → UHC-46437-60 (Brenda Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009751 | Orphan claim re-pointed Claims processor | CLM-422107 → UHC-46336-83 (Olivia Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009752 | Orphan claim re-pointed Claims processor | CLM-401055 → UHC-79809-95 (Sophia Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009753 | Orphan claim re-pointed Claims processor | CLM-405035 → UHC-07597-48 (Carlos Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009754 | Orphan claim re-pointed Claims processor | CLM-401440 → UHC-59211-88 (Bruce Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009755 | Orphan claim re-pointed Claims processor | CLM-402833 → UHC-33757-50 (Martha Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009756 | Orphan claim re-pointed Claims processor | CLM-416639 → UHC-43941-81 (Ralph Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009757 | Orphan claim re-pointed Claims processor | CLM-403603 → UHC-46761-66 (Peter Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009758 | Orphan claim re-pointed Claims processor | CLM-407256 → UHC-64736-32 (Jonathan Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009759 | Orphan claim re-pointed Claims processor | CLM-420003 → UHC-44942-90 (Ann Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009760 | Orphan claim re-pointed Claims processor | CLM-417635 → UHC-05308-73 (Jones Brian) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009761 | Orphan claim re-pointed Claims processor | CLM-413363 → UHC-09140-27 (Anrew Ramos) |
| 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.