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-004040 | Orphan claim re-pointed Claims processor | CLM-415699 → UHC-13174-98 (Judy Burns) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004041 | Orphan claim re-pointed Claims processor | CLM-415867 → UHC-71808-02 (George Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004042 | Orphan claim re-pointed Claims processor | CLM-407001 → UHC-89166-23 (Samantha Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004043 | Orphan claim re-pointed Claims processor | CLM-401493 → UHC-06635-80 (Bruce Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004044 | Orphan claim re-pointed Claims processor | CLM-425800 → UHC-51264-75 (Scott Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004045 | Orphan claim re-pointed Claims processor | CLM-430501 → UHC-52246-95 (Jose Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004046 | Orphan claim re-pointed Claims processor | CLM-421617 → UHC-70359-74 (Victoria Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004047 | Orphan claim re-pointed Claims processor | CLM-414536 → UHC-07135-27 (Sofia Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004048 | Orphan claim re-pointed Claims processor | CLM-402964 → UHC-03938-67 (Ryan Bennett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004049 | Orphan claim re-pointed Claims processor | CLM-414174 → UHC-02130-07 (Henry Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004050 | Orphan claim re-pointed Claims processor | CLM-415161 → UHC-12236-44 (Susan Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004051 | Orphan claim re-pointed Claims processor | CLM-418730 → UHC-43631-44 (Eugene Nunez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004052 | Orphan claim re-pointed Claims processor | CLM-432058 → UHC-84958-95 (Randy Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004053 | Orphan claim re-pointed Claims processor | CLM-428838 → UHC-38871-63 (Sandra Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004054 | Orphan claim re-pointed Claims processor | CLM-430015 → UHC-29472-90 (Timothy Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004055 | Orphan claim re-pointed Claims processor | CLM-413065 → UHC-54078-08 (Jack Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004056 | Orphan claim re-pointed Claims processor | CLM-407466 → UHC-39735-08 (Barbara Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004057 | Orphan claim re-pointed Claims processor | CLM-402864 → UHC-24915-15 (Marilyn Carpneter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004058 | Orphan claim re-pointed Claims processor | CLM-431608 → UHC-13335-70 (Maria Chavez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004059 | Orphan claim re-pointed Claims processor | CLM-403688 → UHC-08034-63 (Valentina Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004060 | Orphan claim re-pointed Claims processor | CLM-431566 → UHC-14304-43 (Lawrence Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004061 | Orphan claim re-pointed Claims processor | CLM-403987 → UHC-26454-12 (Cynthia Burton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004062 | Orphan claim re-pointed Claims processor | CLM-431573 → UHC-46069-48 (Catherine Wright) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004063 | Orphan claim re-pointed Claims processor | CLM-421197 → UHC-78690-13 (Madison Guzman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004064 | Orphan claim re-pointed Claims processor | CLM-408757 → UHC-91272-09 (Timothy Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004065 | Orphan claim re-pointed Claims processor | CLM-429173 → UHC-31565-20 (Judy Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004066 | Orphan claim re-pointed Claims processor | CLM-420743 → UHC-36303-02 (Jennifer Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004067 | Orphan claim re-pointed Claims processor | CLM-414349 → UHC-42128-21 (Wei Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004068 | Orphan claim re-pointed Claims processor | CLM-405510 → UHC-23098-85 (Larry Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004069 | Orphan claim re-pointed Claims processor | CLM-428172 → UHC-16590-26 (Jerry Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004070 | Orphan claim re-pointed Claims processor | CLM-429522 → UHC-45561-96 (Aisha Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004071 | Orphan claim re-pointed Claims processor | CLM-405485 → UHC-80478-13 (Luis Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004072 | Orphan claim re-pointed Claims processor | CLM-423386 → UHC-67838-83 (Matthew Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004073 | Orphan claim re-pointed Claims processor | CLM-418404 → UHC-94887-37 (Ann Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004074 | Orphan claim re-pointed Claims processor | CLM-413700 → UHC-94110-47 (Vincent Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004075 | Orphan claim re-pointed Claims processor | CLM-423789 → UHC-71415-88 (Barbara Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004076 | Orphan claim re-pointed Claims processor | CLM-423463 → UHC-49345-21 (James Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004077 | Orphan claim re-pointed Claims processor | CLM-425594 → UHC-44943-48 (Sandra Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004078 | Orphan claim re-pointed Claims processor | CLM-425951 → UHC-55080-97 (Brandon Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004079 | Orphan claim re-pointed Claims processor | CLM-405216 → UHC-80110-73 (Carol Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004080 | Orphan claim re-pointed Claims processor | CLM-402035 → UHC-89943-08 (Martha Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004081 | Orphan claim re-pointed Claims processor | CLM-405760 → UHC-34428-44 (Billy King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004082 | Orphan claim re-pointed Claims processor | CLM-400418 → UHC-84278-91 (Gregory Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004083 | Orphan claim re-pointed Claims processor | CLM-423673 → UHC-93883-15 (Albert Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004084 | Orphan claim re-pointed Claims processor | CLM-430130 → UHC-63557-36 (Amanda Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004085 | Orphan claim re-pointed Claims processor | CLM-424859 → UHC-00317-15 (Stephanie Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004086 | Orphan claim re-pointed Claims processor | CLM-410315 → UHC-23819-12 (Donna Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004087 | Orphan claim re-pointed Claims processor | CLM-428373 → UHC-01467-69 (Ronald Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004088 | Orphan claim re-pointed Claims processor | CLM-408384 → UHC-20007-69 (Joe Robinson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004089 | Orphan claim re-pointed Claims processor | CLM-431228 → UHC-79001-22 (Jeremy Garrett) |
| 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.