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-002990 | Orphan claim re-pointed Claims processor | CLM-406552 → UHC-60822-04 (Martha Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002991 | Orphan claim re-pointed Claims processor | CLM-411223 → UHC-63213-46 (Donald Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002992 | Orphan claim re-pointed Claims processor | CLM-407649 → UHC-48905-18 (Austin Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002993 | Orphan claim re-pointed Claims processor | CLM-426806 → UHC-41493-30 (Jessica Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002994 | Orphan claim re-pointed Claims processor | CLM-402153 → UHC-80131-43 (Mary Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002995 | Orphan claim re-pointed Claims processor | CLM-408711 → UHC-66102-15 (Virginia Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002996 | Orphan claim re-pointed Claims processor | CLM-429981 → UHC-32999-29 (Susan Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002997 | Orphan claim re-pointed Claims processor | CLM-417611 → UHC-58714-51 (Mei Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002998 | Orphan claim re-pointed Claims processor | CLM-421681 → UHC-35330-66 (Abigail Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-002999 | Orphan claim re-pointed Claims processor | CLM-421831 → UHC-14190-34 (Carl Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003000 | Orphan claim re-pointed Claims processor | CLM-422619 → UHC-50635-73 (Danielle Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003001 | Orphan claim re-pointed Claims processor | CLM-415428 → UHC-21356-89 (Cynthia Alvarez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003002 | Orphan claim re-pointed Claims processor | CLM-426075 → UHC-20813-41 (Dorothy Peterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003003 | Orphan claim re-pointed Claims processor | CLM-414984 → UHC-76613-51 (Judith Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003004 | Orphan claim re-pointed Claims processor | CLM-428404 → UHC-83800-79 (Julie Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003005 | Orphan claim re-pointed Claims processor | CLM-430383 → UHC-80730-37 (Karen Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003006 | Orphan claim re-pointed Claims processor | CLM-425854 → UHC-91907-85 (Jose Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003007 | Orphan claim re-pointed Claims processor | CLM-413855 → UHC-26778-24 (Sandra Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003008 | Orphan claim re-pointed Claims processor | CLM-428318 → UHC-40643-26 (Alice Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003009 | Orphan claim re-pointed Claims processor | CLM-422454 → UHC-60118-16 (Brittany Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003010 | Orphan claim re-pointed Claims processor | CLM-417534 → UHC-19407-98 (Jose Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003011 | Orphan claim re-pointed Claims processor | CLM-401630 → UHC-29560-29 (Kathleen Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003012 | Orphan claim re-pointed Claims processor | CLM-420106 → UHC-03354-04 (Zachary Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003013 | Orphan claim re-pointed Claims processor | CLM-413531 → UHC-69055-38 (Brian Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003014 | Orphan claim re-pointed Claims processor | CLM-423000 → UHC-81991-63 (Ashley Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003015 | Orphan claim re-pointed Claims processor | CLM-427265 → UHC-04166-33 (Doris Ryan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003016 | Orphan claim re-pointed Claims processor | CLM-412034 → UHC-43336-98 (Yuki Hunter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003017 | Orphan claim re-pointed Claims processor | CLM-402646 → UHC-64475-41 (Joyce Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003018 | Orphan claim re-pointed Claims processor | CLM-426943 → UHC-58714-09 (Katherine Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003019 | Orphan claim re-pointed Claims processor | CLM-400534 → UHC-65574-14 (Carl Jacobs) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003020 | Orphan claim re-pointed Claims processor | CLM-420994 → UHC-50500-21 (Ruth Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003021 | Orphan claim re-pointed Claims processor | CLM-416428 → UHC-43474-82 (Ralph Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003022 | Orphan claim re-pointed Claims processor | CLM-425959 → UHC-03338-45 (Aisha Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003023 | Orphan claim re-pointed Claims processor | CLM-419063 → UHC-44726-52 (Wayne Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003024 | Orphan claim re-pointed Claims processor | CLM-424316 → UHC-64314-13 (Emily Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003025 | Orphan claim re-pointed Claims processor | CLM-424816 → UHC-78961-66 (Amy Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003026 | Orphan claim re-pointed Claims processor | CLM-422979 → UHC-73169-03 (Kayla Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003027 | Orphan claim re-pointed Claims processor | CLM-409339 → UHC-15649-07 (Bryan Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003028 | Orphan claim re-pointed Claims processor | CLM-429574 → UHC-49733-88 (Dorothy Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003029 | Orphan claim re-pointed Claims processor | CLM-409160 → UHC-82037-47 (Evelyn Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003030 | Orphan claim re-pointed Claims processor | CLM-429965 → UHC-63818-98 (Janice Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003031 | Orphan claim re-pointed Claims processor | CLM-429271 → UHC-24025-42 (Kayla Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003032 | Orphan claim re-pointed Claims processor | CLM-403747 → UHC-17557-30 (Cynthia Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003033 | Orphan claim re-pointed Claims processor | CLM-404781 → UHC-69416-72 (Elijah Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003034 | Orphan claim re-pointed Claims processor | CLM-409502 → UHC-68420-99 (Adam Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003035 | Orphan claim re-pointed Claims processor | CLM-404092 → UHC-44276-58 (Jeremy Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003036 | Orphan claim re-pointed Claims processor | CLM-414055 → UHC-64849-57 (Katherine Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003037 | Orphan claim re-pointed Claims processor | CLM-413402 → UHC-92235-70 (Michelle Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003038 | Orphan claim re-pointed Claims processor | CLM-432603 → UHC-21303-62 (Maria Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003039 | Orphan claim re-pointed Claims processor | CLM-426193 → UHC-55817-74 (Stephen Meyer) |
| 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.