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-003040 | Orphan claim re-pointed Claims processor | CLM-425557 → UHC-98623-51 (Kelly Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003041 | Orphan claim re-pointed Claims processor | CLM-413577 → UHC-04229-09 (Philip Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003042 | Orphan claim re-pointed Claims processor | CLM-403226 → UHC-64259-10 (Yuki Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003043 | Orphan claim re-pointed Claims processor | CLM-419615 → UHC-80234-32 (Lawrence Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003044 | Orphan claim re-pointed Claims processor | CLM-409497 → UHC-35903-72 (Rebecca Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003045 | Orphan claim re-pointed Claims processor | CLM-428491 → UHC-59733-49 (Rachel Russell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003046 | Orphan claim re-pointed Claims processor | CLM-432657 → UHC-92766-64 (Sean Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003047 | Orphan claim re-pointed Claims processor | CLM-415228 → UHC-04658-83 (Carlos Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003048 | Orphan claim re-pointed Claims processor | CLM-419325 → UHC-54283-43 (Cheryl Garcia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003049 | Orphan claim re-pointed Claims processor | CLM-404962 → UHC-42310-56 (Gary Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003050 | Orphan claim re-pointed Claims processor | CLM-424772 → UHC-03381-49 (Andrea Carlson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003051 | Orphan claim re-pointed Claims processor | CLM-408651 → UHC-87938-64 (Katherine Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003052 | Orphan claim re-pointed Claims processor | CLM-422881 → UHC-10931-15 (Jonathan Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003053 | Orphan claim re-pointed Claims processor | CLM-430895 → UHC-05548-06 (Katherine Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003054 | Orphan claim re-pointed Claims processor | CLM-400910 → UHC-48195-05 (Terry Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003055 | Orphan claim re-pointed Claims processor | CLM-401234 → UHC-19454-66 (Amanda Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003056 | Orphan claim re-pointed Claims processor | CLM-416664 → UHC-37231-04 (Hannah McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003057 | Orphan claim re-pointed Claims processor | CLM-429221 → UHC-69901-39 (Aisha Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003058 | Orphan claim re-pointed Claims processor | CLM-414930 → UHC-38548-43 (Abigail Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003059 | Orphan claim re-pointed Claims processor | CLM-416432 → UHC-49808-01 (Douglas Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003060 | Orphan claim re-pointed Claims processor | CLM-402124 → UHC-51969-60 (Isabella Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003061 | Orphan claim re-pointed Claims processor | CLM-420289 → UHC-42069-39 (Sarah Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003062 | Orphan claim re-pointed Claims processor | CLM-412321 → UHC-99279-22 (Terry Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003063 | Orphan claim re-pointed Claims processor | CLM-421416 → UHC-56962-17 (Rebecca Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003064 | Orphan claim re-pointed Claims processor | CLM-406028 → UHC-17618-84 (Douglas Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003065 | Orphan claim re-pointed Claims processor | CLM-427451 → UHC-34576-96 (Kathryn Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003066 | Orphan claim re-pointed Claims processor | CLM-400782 → UHC-70675-02 (Fatima Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003067 | Orphan claim re-pointed Claims processor | CLM-416592 → UHC-34893-97 (Sharon Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003068 | Orphan claim re-pointed Claims processor | CLM-405283 → UHC-05707-46 (Laura Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003069 | Orphan claim re-pointed Claims processor | CLM-412593 → UHC-68353-50 (Jordan Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003070 | Orphan claim re-pointed Claims processor | CLM-412323 → UHC-42796-35 (Charlotte Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003071 | Orphan claim re-pointed Claims processor | CLM-409409 → UHC-75227-24 (Larry Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003072 | Orphan claim re-pointed Claims processor | CLM-416311 → UHC-08695-23 (Walter Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003073 | Orphan claim re-pointed Claims processor | CLM-424433 → UHC-32298-88 (Samuel Nguyen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003074 | Orphan claim re-pointed Claims processor | CLM-418084 → UHC-36547-91 (Noah Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003075 | Orphan claim re-pointed Claims processor | CLM-432007 → UHC-71365-75 (Diane Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003076 | Orphan claim re-pointed Claims processor | CLM-401855 → UHC-58248-42 (Edward Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003077 | Orphan claim re-pointed Claims processor | CLM-411022 → UHC-28637-03 (Gloria Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003078 | Orphan claim re-pointed Claims processor | CLM-429862 → UHC-72812-48 (Sara Murphy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003079 | Orphan claim re-pointed Claims processor | CLM-432343 → UHC-73398-16 (Ethan Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003080 | Orphan claim re-pointed Claims processor | CLM-415370 → UHC-39357-75 (Michelle Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003081 | Orphan claim re-pointed Claims processor | CLM-410276 → UHC-81219-28 (Martha Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003082 | Orphan claim re-pointed Claims processor | CLM-411492 → UHC-44996-73 (Gerald Marquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003083 | Orphan claim re-pointed Claims processor | CLM-401756 → UHC-09575-01 (Juan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003084 | Orphan claim re-pointed Claims processor | CLM-424290 → UHC-85609-56 (Martha Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003085 | Orphan claim re-pointed Claims processor | CLM-406222 → UHC-81705-08 (Bowman Emma) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003086 | Orphan claim re-pointed Claims processor | CLM-417026 → UHC-33520-63 (Gerald Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003087 | Orphan claim re-pointed Claims processor | CLM-407861 → UHC-87899-87 (Marilyn Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003088 | Orphan claim re-pointed Claims processor | CLM-408042 → UHC-75070-81 (Heather Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003089 | Orphan claim re-pointed Claims processor | CLM-413922 → UHC-31143-91 (Martha Boyd) |
| 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.