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-003240 | Orphan claim re-pointed Claims processor | CLM-422442 → UHC-22819-36 (Emma Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003241 | Orphan claim re-pointed Claims processor | CLM-418490 → UHC-39290-06 (Linda Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003242 | Orphan claim re-pointed Claims processor | CLM-427235 → UHC-12535-13 (Joseph Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003243 | Orphan claim re-pointed Claims processor | CLM-418773 → UHC-04889-09 (Alice Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003244 | Orphan claim re-pointed Claims processor | CLM-406871 → UHC-12751-91 (Aaron Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003245 | Orphan claim re-pointed Claims processor | CLM-421288 → UHC-37929-30 (Lawrence Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003246 | Orphan claim re-pointed Claims processor | CLM-415873 → UHC-14307-75 (Judy Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003247 | Orphan claim re-pointed Claims processor | CLM-421785 → UHC-71838-89 (Roger Dominguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003248 | Orphan claim re-pointed Claims processor | CLM-422258 → UHC-69469-95 (Albert Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003249 | Orphan claim re-pointed Claims processor | CLM-402688 → UHC-16878-36 (Noah Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003250 | Orphan claim re-pointed Claims processor | CLM-404121 → UHC-51711-74 (Lisa Walker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003251 | Orphan claim re-pointed Claims processor | CLM-407684 → UHC-79068-41 (Mark Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003252 | Orphan claim re-pointed Claims processor | CLM-404077 → UHC-69805-53 (Sandra Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003253 | Orphan claim re-pointed Claims processor | CLM-423636 → UHC-18220-29 (Olivia Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003254 | Orphan claim re-pointed Claims processor | CLM-403252 → UHC-76538-79 (Terry Rodriugez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003255 | Orphan claim re-pointed Claims processor | CLM-424934 → UHC-38887-29 (Jeffrey Jenkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003256 | Orphan claim re-pointed Claims processor | CLM-427215 → UHC-55178-78 (Ashley Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003257 | Orphan claim re-pointed Claims processor | CLM-412882 → UHC-01923-32 (James Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003258 | Orphan claim re-pointed Claims processor | CLM-408029 → UHC-52299-91 (Virginia Hughes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003259 | Orphan claim re-pointed Claims processor | CLM-411996 → UHC-87060-63 (Briaan Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003260 | Orphan claim re-pointed Claims processor | CLM-426915 → UHC-92801-47 (Susan Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003261 | Orphan claim re-pointed Claims processor | CLM-424396 → UHC-52523-92 (Randy Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003262 | Orphan claim re-pointed Claims processor | CLM-422265 → UHC-72889-66 (Mark Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003263 | Orphan claim re-pointed Claims processor | CLM-423867 → UHC-20959-12 (Ronald Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003264 | Orphan claim re-pointed Claims processor | CLM-424591 → UHC-63153-81 (Paul Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003265 | Orphan claim re-pointed Claims processor | CLM-420729 → UHC-57748-11 (Ronald Mitchell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003266 | Orphan claim re-pointed Claims processor | CLM-406948 → UHC-83147-93 (Vincent Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003267 | Orphan claim re-pointed Claims processor | CLM-407341 → UHC-97852-59 (Carolyn Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003268 | Orphan claim re-pointed Claims processor | CLM-426129 → UHC-18976-70 (James Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003269 | Orphan claim re-pointed Claims processor | CLM-428413 → UHC-47454-98 (William Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003270 | Orphan claim re-pointed Claims processor | CLM-426473 → UHC-96293-49 (Deborah Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003271 | Orphan claim re-pointed Claims processor | CLM-412273 → UHC-76708-28 (Thomas Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003272 | Orphan claim re-pointed Claims processor | CLM-400577 → UHC-32829-25 (Ronald Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003273 | Orphan claim re-pointed Claims processor | CLM-432502 → UHC-88692-40 (Lori Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003274 | Orphan claim re-pointed Claims processor | CLM-409426 → UHC-11986-61 (Brandon Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003275 | Orphan claim re-pointed Claims processor | CLM-425038 → UHC-64570-80 (Kathryn Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003276 | Orphan claim re-pointed Claims processor | CLM-414905 → UHC-00467-13 (Alert James) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003277 | Orphan claim re-pointed Claims processor | CLM-404371 → UHC-68806-30 (Anthony Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003278 | Orphan claim re-pointed Claims processor | CLM-418795 → UHC-51875-33 (Donald Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003279 | Orphan claim re-pointed Claims processor | CLM-403138 → UHC-98539-12 (Mei Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003280 | Orphan claim re-pointed Claims processor | CLM-432596 → UHC-45306-29 (Emily Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003281 | Orphan claim re-pointed Claims processor | CLM-410148 → UHC-40867-57 (Alexis Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003282 | Orphan claim re-pointed Claims processor | CLM-404942 → UHC-05073-10 (Russell Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003283 | Orphan claim re-pointed Claims processor | CLM-406375 → UHC-84795-06 (Ajun Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003284 | Orphan claim re-pointed Claims processor | CLM-430457 → UHC-50436-75 (Benjamin Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003285 | Orphan claim re-pointed Claims processor | CLM-424210 → UHC-04826-75 (Anna Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003286 | Orphan claim re-pointed Claims processor | CLM-430540 → UHC-13421-40 (Sandra White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003287 | Orphan claim re-pointed Claims processor | CLM-429479 → UHC-16406-79 (Denise Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003288 | Orphan claim re-pointed Claims processor | CLM-410664 → UHC-08940-62 (Carolyn King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003289 | Orphan claim re-pointed Claims processor | CLM-407616 → UHC-91769-61 (Barbara Rojas) |
| 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.