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-003590 | Orphan claim re-pointed Claims processor | CLM-431051 → UHC-73405-81 (Andrew Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003591 | Orphan claim re-pointed Claims processor | CLM-403731 → UHC-53980-36 (Jessica Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003592 | Orphan claim re-pointed Claims processor | CLM-431736 → UHC-18114-77 (Arthur Valdez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003593 | Orphan claim re-pointed Claims processor | CLM-406057 → UHC-64556-29 (Zachary Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003594 | Orphan claim re-pointed Claims processor | CLM-412118 → UHC-38053-93 (Aaron Daniels) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003595 | Orphan claim re-pointed Claims processor | CLM-420326 → UHC-58353-57 (Drew Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003596 | Orphan claim re-pointed Claims processor | CLM-420960 → UHC-52307-49 (William Freeman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003597 | Orphan claim re-pointed Claims processor | CLM-401901 → UHC-39209-26 (Samuel Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003598 | Orphan claim re-pointed Claims processor | CLM-421045 → UHC-99344-22 (Joshua Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003599 | Orphan claim re-pointed Claims processor | CLM-401740 → UHC-00302-33 (Teresa Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003600 | Orphan claim re-pointed Claims processor | CLM-424552 → UHC-69765-55 (Blily Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003601 | Orphan claim re-pointed Claims processor | CLM-426494 → UHC-80724-56 (Amanda McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003602 | Orphan claim re-pointed Claims processor | CLM-404151 → UHC-49265-38 (Paul Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003603 | Orphan claim re-pointed Claims processor | CLM-428999 → UHC-30649-64 (Mason Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003604 | Orphan claim re-pointed Claims processor | CLM-414183 → UHC-78903-55 (Emma Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003605 | Orphan claim re-pointed Claims processor | CLM-421649 → UHC-53180-18 (Mark Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003606 | Orphan claim re-pointed Claims processor | CLM-406352 → UHC-40218-11 (Angela Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003607 | Orphan claim re-pointed Claims processor | CLM-426142 → UHC-74179-83 (Terry Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003608 | Orphan claim re-pointed Claims processor | CLM-403905 → UHC-12107-12 (Ralph Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003609 | Orphan claim re-pointed Claims processor | CLM-429715 → UHC-38570-43 (Gloria Martin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003610 | Orphan claim re-pointed Claims processor | CLM-421533 → UHC-20155-17 (Gregory Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003611 | Orphan claim re-pointed Claims processor | CLM-409291 → UHC-43144-61 (Benjamin Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003612 | Orphan claim re-pointed Claims processor | CLM-413891 → UHC-98772-34 (Julia Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003613 | Orphan claim re-pointed Claims processor | CLM-417734 → UHC-17167-67 (Wayne Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003614 | Orphan claim re-pointed Claims processor | CLM-417552 → UHC-10019-54 (Albert Cruz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003615 | Orphan claim re-pointed Claims processor | CLM-428511 → UHC-54516-18 (Hannah Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003616 | Orphan claim re-pointed Claims processor | CLM-406695 → UHC-65859-51 (Deborah Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003617 | Orphan claim re-pointed Claims processor | CLM-403150 → UHC-95688-46 (Diego Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003618 | Orphan claim re-pointed Claims processor | CLM-414917 → UHC-86231-01 (Christina Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003619 | Orphan claim re-pointed Claims processor | CLM-421162 → UHC-43377-08 (Teresa Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003620 | Orphan claim re-pointed Claims processor | CLM-422214 → UHC-15396-79 (Diana Spencer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003621 | Orphan claim re-pointed Claims processor | CLM-420944 → UHC-91116-58 (Russell Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003622 | Orphan claim re-pointed Claims processor | CLM-429647 → UHC-45864-37 (Kenneth Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003623 | Orphan claim re-pointed Claims processor | CLM-416853 → UHC-75899-09 (Jean Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003624 | Orphan claim re-pointed Claims processor | CLM-413923 → UHC-11042-41 (Anthony Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003625 | Orphan claim re-pointed Claims processor | CLM-415218 → UHC-44164-95 (Richard Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003626 | Orphan claim re-pointed Claims processor | CLM-421090 → UHC-58798-14 (David Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003627 | Orphan claim re-pointed Claims processor | CLM-411404 → UHC-39812-09 (Emma Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003628 | Orphan claim re-pointed Claims processor | CLM-430629 → UHC-77280-77 (Barbara Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003629 | Orphan claim re-pointed Claims processor | CLM-404689 → UHC-45993-85 (Ashley Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003630 | Orphan claim re-pointed Claims processor | CLM-431154 → UHC-80704-58 (Patrick Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003631 | Orphan claim re-pointed Claims processor | CLM-430248 → UHC-10245-84 (Russell Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003632 | Orphan claim re-pointed Claims processor | CLM-421460 → UHC-10409-87 (Samantha Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003633 | Orphan claim re-pointed Claims processor | CLM-403986 → UHC-32919-73 (Jennifer Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003634 | Orphan claim re-pointed Claims processor | CLM-429182 → UHC-31006-11 (Megan Richardson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003635 | Orphan claim re-pointed Claims processor | CLM-404973 → UHC-95807-32 (Aaron Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003636 | Orphan claim re-pointed Claims processor | CLM-414187 → UHC-16639-21 (Sarah Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003637 | Orphan claim re-pointed Claims processor | CLM-413459 → UHC-86002-96 (Jason Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003638 | Orphan claim re-pointed Claims processor | CLM-430963 → UHC-19301-15 (Luis Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-003639 | Orphan claim re-pointed Claims processor | CLM-406708 → UHC-09499-92 (Mariana Ortega) |
| 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.