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-009762 | Orphan claim re-pointed Claims processor | CLM-411372 → UHC-22840-88 (Peter Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009763 | Orphan claim re-pointed Claims processor | CLM-418471 → UHC-54920-73 (Madison McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009764 | Orphan claim re-pointed Claims processor | CLM-422680 → UHC-89770-54 (Kathryn Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009765 | Orphan claim re-pointed Claims processor | CLM-432757 → UHC-84285-56 (Adam Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009766 | Orphan claim re-pointed Claims processor | CLM-409341 → UHC-25318-23 (Fatima Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009767 | Orphan claim re-pointed Claims processor | CLM-423668 → UHC-98266-18 (Santiago Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009768 | Orphan claim re-pointed Claims processor | CLM-404675 → UHC-87798-97 (Sophia Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009769 | Orphan claim re-pointed Claims processor | CLM-420665 → UHC-17753-40 (Scott Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009770 | Orphan claim re-pointed Claims processor | CLM-429437 → UHC-74169-30 (Jerry Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009771 | Orphan claim re-pointed Claims processor | CLM-400228 → UHC-87537-12 (Evelyn Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009772 | Orphan claim re-pointed Claims processor | CLM-406738 → UHC-95909-64 (Barbara Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009773 | Orphan claim re-pointed Claims processor | CLM-426120 → UHC-24684-36 (Russell Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009774 | Orphan claim re-pointed Claims processor | CLM-420281 → UHC-99707-79 (Maria Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009775 | Orphan claim re-pointed Claims processor | CLM-420794 → UHC-27291-77 (Diane Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009776 | Orphan claim re-pointed Claims processor | CLM-407201 → UHC-71340-83 (Ralph Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009777 | Orphan claim re-pointed Claims processor | CLM-404265 → UHC-32054-39 (Daniel Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009778 | Orphan claim re-pointed Claims processor | CLM-428349 → UHC-64195-37 (Frances Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009779 | Orphan claim re-pointed Claims processor | CLM-408143 → UHC-50023-54 (Henry Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009780 | Orphan claim re-pointed Claims processor | CLM-408067 → UHC-24246-34 (Christopher Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009781 | Orphan claim re-pointed Claims processor | CLM-427485 → UHC-53237-67 (Kimberly Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009782 | Orphan claim re-pointed Claims processor | CLM-428652 → UHC-34565-98 (Charles Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009783 | Orphan claim re-pointed Claims processor | CLM-415700 → UHC-13174-98 (Judy Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009784 | Orphan claim re-pointed Claims processor | CLM-407579 → UHC-19582-46 (Alice Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009785 | Orphan claim re-pointed Claims processor | CLM-416321 → UHC-50247-35 (Gabriel Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009786 | Orphan claim re-pointed Claims processor | CLM-422200 → UHC-87463-27 (Joyce Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009787 | Orphan claim re-pointed Claims processor | CLM-405436 → UHC-56805-86 (Carlos Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009788 | Orphan claim re-pointed Claims processor | CLM-422204 → UHC-13209-74 (Aaron Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009789 | Orphan claim re-pointed Claims processor | CLM-414845 → UHC-55125-01 (Betty Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009790 | Orphan claim re-pointed Claims processor | CLM-425473 → UHC-33599-32 (Sean Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009791 | Orphan claim re-pointed Claims processor | CLM-406195 → UHC-00138-75 (Fatima Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009792 | Orphan claim re-pointed Claims processor | CLM-414610 → UHC-55711-88 (Kathy Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009793 | Orphan claim re-pointed Claims processor | CLM-430820 → UHC-68161-24 (Timothy Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009794 | Orphan claim re-pointed Claims processor | CLM-430111 → UHC-01242-71 (Frank Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009795 | Orphan claim re-pointed Claims processor | CLM-418153 → UHC-63645-91 (Harold Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009796 | Orphan claim re-pointed Claims processor | CLM-415041 → UHC-63870-54 (Ronald Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009797 | Orphan claim re-pointed Claims processor | CLM-417230 → UHC-88955-23 (Andrea Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009798 | Orphan claim re-pointed Claims processor | CLM-411622 → UHC-88620-39 (Brandon Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009799 | Orphan claim re-pointed Claims processor | CLM-405441 → UHC-00989-26 (Diana Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009800 | Orphan claim re-pointed Claims processor | CLM-410913 → UHC-70981-11 (Diana Chapman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009801 | Orphan claim re-pointed Claims processor | CLM-421924 → UHC-34912-88 (Theresa Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009802 | Orphan claim re-pointed Claims processor | CLM-428862 → UHC-46807-70 (Arthur Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009803 | Orphan claim re-pointed Claims processor | CLM-418385 → UHC-94457-68 (David Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009804 | Orphan claim re-pointed Claims processor | CLM-412693 → UHC-07446-40 (Isabella Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009805 | Orphan claim re-pointed Claims processor | CLM-407374 → UHC-52585-76 (Santiago Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009806 | Orphan claim re-pointed Claims processor | CLM-420981 → UHC-63371-59 (Andrew Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009807 | Orphan claim re-pointed Claims processor | CLM-421869 → UHC-92926-86 (Brenda Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009808 | Orphan claim re-pointed Claims processor | CLM-414997 → UHC-13776-69 (Anthony Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009809 | Orphan claim re-pointed Claims processor | CLM-412333 → UHC-82124-06 (Keith McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009810 | Orphan claim re-pointed Claims processor | CLM-424838 → UHC-05807-14 (James Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009811 | Orphan claim re-pointed Claims processor | CLM-406493 → UHC-97310-50 (Luis 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.