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-004140 | Orphan claim re-pointed Claims processor | CLM-408726 → UHC-13516-97 (Sean Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004141 | Orphan claim re-pointed Claims processor | CLM-412750 → UHC-22076-21 (Kimberly Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004142 | Orphan claim re-pointed Claims processor | CLM-414666 → UHC-82468-07 (Christine Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004143 | Orphan claim re-pointed Claims processor | CLM-429659 → UHC-35789-57 (Betty Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004144 | Orphan claim re-pointed Claims processor | CLM-423744 → UHC-17038-94 (Jorddan Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004145 | Orphan claim re-pointed Claims processor | CLM-432624 → UHC-30304-46 (Alice Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004146 | Orphan claim re-pointed Claims processor | CLM-427988 → UHC-92885-35 (Sharon Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004147 | Orphan claim re-pointed Claims processor | CLM-414533 → UHC-99901-23 (Patricia Wang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004148 | Orphan claim re-pointed Claims processor | CLM-413470 → UHC-48919-48 (Anna Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004149 | Orphan claim re-pointed Claims processor | CLM-412381 → UHC-71299-67 (Donald Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004150 | Orphan claim re-pointed Claims processor | CLM-411041 → UHC-71249-10 (Charlotte Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004151 | Orphan claim re-pointed Claims processor | CLM-403145 → UHC-22094-51 (Joshua Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004152 | Orphan claim re-pointed Claims processor | CLM-414699 → UHC-22962-32 (Vincent Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004153 | Orphan claim re-pointed Claims processor | CLM-402341 → UHC-46654-44 (Aisha Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004154 | Orphan claim re-pointed Claims processor | CLM-429051 → UHC-36756-03 (William Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004155 | Orphan claim re-pointed Claims processor | CLM-428476 → UHC-68989-04 (Betty Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004156 | Orphan claim re-pointed Claims processor | CLM-413564 → UHC-64051-25 (Sophia Roberts) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004157 | Orphan claim re-pointed Claims processor | CLM-411348 → UHC-31410-22 (Alexander Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004158 | Orphan claim re-pointed Claims processor | CLM-426363 → UHC-65661-91 (Andrew Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004159 | Orphan claim re-pointed Claims processor | CLM-407240 → UHC-32210-74 (Grace Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004160 | Orphan claim re-pointed Claims processor | CLM-428314 → UHC-40862-03 (David Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004161 | Orphan claim re-pointed Claims processor | CLM-408595 → UHC-47574-41 (Tyler McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004162 | Orphan claim re-pointed Claims processor | CLM-415913 → UHC-83792-17 (Harold Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004163 | Orphan claim re-pointed Claims processor | CLM-405444 → UHC-87174-74 (Jason Mills) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004164 | Orphan claim re-pointed Claims processor | CLM-421536 → UHC-32156-74 (Christian Mendez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004165 | Orphan claim re-pointed Claims processor | CLM-418420 → UHC-78519-23 (Joseph Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004166 | Orphan claim re-pointed Claims processor | CLM-424050 → UHC-34140-62 (Dorothy Henderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004167 | Orphan claim re-pointed Claims processor | CLM-409699 → UHC-03553-42 (Crawford Lori) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004168 | Orphan claim re-pointed Claims processor | CLM-409480 → UHC-25227-10 (Kyle Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004169 | Orphan claim re-pointed Claims processor | CLM-420260 → UHC-55158-75 (Joe Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004170 | Orphan claim re-pointed Claims processor | CLM-422069 → UHC-12199-64 (Fatima Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004171 | Orphan claim re-pointed Claims processor | CLM-406853 → UHC-15169-15 (Jerry Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004172 | Orphan claim re-pointed Claims processor | CLM-415332 → UHC-84180-72 (Nancy Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004173 | Orphan claim re-pointed Claims processor | CLM-416096 → UHC-12370-45 (Sandra Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004174 | Orphan claim re-pointed Claims processor | CLM-401323 → UHC-24513-24 (Helen Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004175 | Orphan claim re-pointed Claims processor | CLM-404290 → UHC-81208-98 (Joseph Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004176 | Orphan claim re-pointed Claims processor | CLM-421148 → UHC-58570-09 (Maria Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004177 | Orphan claim re-pointed Claims processor | CLM-406019 → UHC-73426-48 (Kayla Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004178 | Orphan claim re-pointed Claims processor | CLM-428333 → UHC-38072-86 (Danielle Grant) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004179 | Orphan claim re-pointed Claims processor | CLM-422604 → UHC-33618-37 (Dylan Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004180 | Orphan claim re-pointed Claims processor | CLM-427566 → UHC-60412-92 (Barbara Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004181 | Orphan claim re-pointed Claims processor | CLM-414799 → UHC-81288-01 (Billy Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004182 | Orphan claim re-pointed Claims processor | CLM-418542 → UHC-42672-48 (Kayla Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004183 | Orphan claim re-pointed Claims processor | CLM-425463 → UHC-08732-87 (Teresa Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004184 | Orphan claim re-pointed Claims processor | CLM-416041 → UHC-11060-89 (Kathryn Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004185 | Orphan claim re-pointed Claims processor | CLM-425832 → UHC-92716-76 (Anna Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004186 | Orphan claim re-pointed Claims processor | CLM-413514 → UHC-59451-69 (Brian Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004187 | Orphan claim re-pointed Claims processor | CLM-402717 → UHC-78593-05 (Wayne Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004188 | Orphan claim re-pointed Claims processor | CLM-413466 → UHC-08157-31 (Mark Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004189 | Orphan claim re-pointed Claims processor | CLM-414803 → UHC-45571-88 (Bradley Weber) |
| 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.