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-009812 | Orphan claim re-pointed Claims processor | CLM-405546 → UHC-96787-07 (Katherine Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009813 | Orphan claim re-pointed Claims processor | CLM-410045 → UHC-92857-60 (Sean Sean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009814 | Orphan claim re-pointed Claims processor | CLM-422224 → UHC-83444-60 (Billy Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009815 | Orphan claim re-pointed Claims processor | CLM-419833 → UHC-11708-31 (Albert Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009816 | Orphan claim re-pointed Claims processor | CLM-407983 → UHC-93859-39 (Sara Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009817 | Orphan claim re-pointed Claims processor | CLM-400429 → UHC-60033-71 (Bradley Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009818 | Orphan claim re-pointed Claims processor | CLM-400440 → UHC-48650-39 (Juan Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009819 | Orphan claim re-pointed Claims processor | CLM-426117 → UHC-81435-34 (Kathleen Bryant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009820 | Orphan claim re-pointed Claims processor | CLM-426386 → UHC-77668-48 (Linda Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009821 | Orphan claim re-pointed Claims processor | CLM-424755 → UHC-15768-95 (Christine Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009822 | Orphan claim re-pointed Claims processor | CLM-424741 → UHC-10537-45 (Santiago Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009823 | Orphan claim re-pointed Claims processor | CLM-417634 → UHC-93885-30 (Adam Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009824 | Orphan claim re-pointed Claims processor | CLM-426784 → UHC-75200-93 (Angela Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009825 | Orphan claim re-pointed Claims processor | CLM-410323 → UHC-25496-41 (Tyler Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009826 | Orphan claim re-pointed Claims processor | CLM-425908 → UHC-17034-92 (Sarah Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009827 | Orphan claim re-pointed Claims processor | CLM-409429 → UHC-43731-30 (Nancy Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009828 | Orphan claim re-pointed Claims processor | CLM-422410 → UHC-97279-29 (Joseph Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009829 | Orphan claim re-pointed Claims processor | CLM-407522 → UHC-46334-94 (Keith Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009830 | Orphan claim re-pointed Claims processor | CLM-404409 → UHC-78331-45 (Matthew White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009831 | Orphan claim re-pointed Claims processor | CLM-424514 → UHC-83159-99 (James Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009832 | Orphan claim re-pointed Claims processor | CLM-407725 → UHC-99654-35 (Carlos Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009833 | Orphan claim re-pointed Claims processor | CLM-422291 → UHC-85073-69 (Logan Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009834 | Orphan claim re-pointed Claims processor | CLM-409785 → UHC-13667-19 (Mariana Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009835 | Orphan claim re-pointed Claims processor | CLM-430967 → UHC-79600-13 (Frank Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009836 | Orphan claim re-pointed Claims processor | CLM-422969 → UHC-80359-24 (Carol Pierce) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009837 | Orphan claim re-pointed Claims processor | CLM-427417 → UHC-09454-42 (Karen Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009838 | Orphan claim re-pointed Claims processor | CLM-431607 → UHC-47185-87 (Kelly Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009839 | Orphan claim re-pointed Claims processor | CLM-427766 → UHC-93261-88 (Anthony Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009840 | Orphan claim re-pointed Claims processor | CLM-415192 → UHC-25116-10 (Arthur Morgan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009841 | Orphan claim re-pointed Claims processor | CLM-406016 → UHC-32609-65 (Deborah Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009842 | Orphan claim re-pointed Claims processor | CLM-426645 → UHC-22256-78 (Teresa Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009843 | Orphan claim re-pointed Claims processor | CLM-409466 → UHC-82176-57 (Wayne Diez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009844 | Orphan claim re-pointed Claims processor | CLM-424471 → UHC-86329-56 (Gerald Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009845 | Orphan claim re-pointed Claims processor | CLM-410891 → UHC-91757-89 (Katherine Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009846 | Orphan claim re-pointed Claims processor | CLM-414948 → UHC-68184-37 (Randy Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009847 | Orphan claim re-pointed Claims processor | CLM-429457 → UHC-11839-77 (Harold Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009848 | Orphan claim re-pointed Claims processor | CLM-406541 → UHC-80241-67 (Walter Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009849 | Orphan claim re-pointed Claims processor | CLM-411228 → UHC-00788-94 (Jacob Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009850 | Orphan claim re-pointed Claims processor | CLM-432725 → UHC-88260-03 (Ana Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009851 | Orphan claim re-pointed Claims processor | CLM-407461 → UHC-46515-10 (Carolyn Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009852 | Orphan claim re-pointed Claims processor | CLM-428558 → UHC-17373-66 (Natalie Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009853 | Orphan claim re-pointed Claims processor | CLM-407918 → UHC-28103-90 (Debra Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009854 | Orphan claim re-pointed Claims processor | CLM-409407 → UHC-98890-36 (Mason Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009855 | Orphan claim re-pointed Claims processor | CLM-423091 → UHC-11916-11 (Amber Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009856 | Orphan claim re-pointed Claims processor | CLM-415846 → UHC-87921-34 (Kayla Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009857 | Orphan claim re-pointed Claims processor | CLM-431080 → UHC-96916-94 (Mei Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009858 | Orphan claim re-pointed Claims processor | CLM-404244 → UHC-31003-23 (Matthew Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009859 | Orphan claim re-pointed Claims processor | CLM-411837 → UHC-67677-60 (Sarah Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009860 | Orphan claim re-pointed Claims processor | CLM-416680 → UHC-27472-49 (Dorothy Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-009861 | Orphan claim re-pointed Claims processor | CLM-420184 → UHC-60924-40 (Brenda Clark) |
| 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.