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-004190 | Orphan claim re-pointed Claims processor | CLM-427268 → UHC-86503-69 (Kyle Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004191 | Orphan claim re-pointed Claims processor | CLM-415674 → UHC-46209-94 (Jacqueline Berry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004192 | Orphan claim re-pointed Claims processor | CLM-412110 → UHC-60017-55 (Jack Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004193 | Orphan claim re-pointed Claims processor | CLM-427760 → UHC-19644-11 (Kimberly Vega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004194 | Orphan claim re-pointed Claims processor | CLM-428116 → UHC-53383-79 (Priya Lopez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004195 | Orphan claim re-pointed Claims processor | CLM-400391 → UHC-22221-92 (Ethan Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004196 | Orphan claim re-pointed Claims processor | CLM-423395 → UHC-06537-09 (Grace Davis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004197 | Orphan claim re-pointed Claims processor | CLM-406235 → UHC-00189-24 (Victoria Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004198 | Orphan claim re-pointed Claims processor | CLM-420209 → UHC-43747-98 (Benjamin Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004199 | Orphan claim re-pointed Claims processor | CLM-421501 → UHC-52381-87 (James Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004200 | Orphan claim re-pointed Claims processor | CLM-401974 → UHC-69978-94 (Justin Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004201 | Orphan claim re-pointed Claims processor | CLM-402118 → UHC-74464-51 (Ray Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004202 | Orphan claim re-pointed Claims processor | CLM-415617 → UHC-04889-62 (Linda Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004203 | Orphan claim re-pointed Claims processor | CLM-425774 → UHC-21911-64 (Joan Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004204 | Orphan claim re-pointed Claims processor | CLM-415511 → UHC-51099-94 (Joyce Moreno) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004205 | Orphan claim re-pointed Claims processor | CLM-431345 → UHC-73203-21 (Dorothy Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004206 | Orphan claim re-pointed Claims processor | CLM-409148 → UHC-39053-23 (Zachary Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004207 | Orphan claim re-pointed Claims processor | CLM-402119 → UHC-74464-51 (Ray Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004208 | Orphan claim re-pointed Claims processor | CLM-418018 → UHC-69446-66 (Jennifer Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004209 | Orphan claim re-pointed Claims processor | CLM-418981 → UHC-03519-46 (Mark Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004210 | Orphan claim re-pointed Claims processor | CLM-400670 → UHC-75388-97 (Melissa Palmer) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004211 | Orphan claim re-pointed Claims processor | CLM-430465 → UHC-96542-58 (Joyce Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004212 | Orphan claim re-pointed Claims processor | CLM-401661 → UHC-51663-15 (Christina Sandoval) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004213 | Orphan claim re-pointed Claims processor | CLM-422723 → UHC-12240-97 (Terry West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004214 | Orphan claim re-pointed Claims processor | CLM-400776 → UHC-11511-21 (Melissa Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004215 | Orphan claim re-pointed Claims processor | CLM-423715 → UHC-89841-95 (Steven Carroll) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004216 | Orphan claim re-pointed Claims processor | CLM-406509 → UHC-88085-99 (Kayla Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004217 | Orphan claim re-pointed Claims processor | CLM-409789 → UHC-41226-01 (Hannah Lewis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004218 | Orphan claim re-pointed Claims processor | CLM-432545 → UHC-65896-08 (Jdy Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004219 | Orphan claim re-pointed Claims processor | CLM-424659 → UHC-16910-09 (Joyce Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004220 | Orphan claim re-pointed Claims processor | CLM-432334 → UHC-55456-32 (Larry Fields) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004221 | Orphan claim re-pointed Claims processor | CLM-418041 → UHC-03727-81 (Madison Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004222 | Orphan claim re-pointed Claims processor | CLM-429132 → UHC-19356-27 (Mary Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004223 | Orphan claim re-pointed Claims processor | CLM-416821 → UHC-45838-06 (Nancy Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004224 | Orphan claim re-pointed Claims processor | CLM-400678 → UHC-23542-94 (Catherine Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004225 | Orphan claim re-pointed Claims processor | CLM-420499 → UHC-11316-19 (Charlotte Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004226 | Orphan claim re-pointed Claims processor | CLM-420786 → UHC-23024-76 (Jordan Li) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004227 | Orphan claim re-pointed Claims processor | CLM-420895 → UHC-43746-71 (Samantha Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004228 | Orphan claim re-pointed Claims processor | CLM-408266 → UHC-66041-95 (Alice Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004229 | Orphan claim re-pointed Claims processor | CLM-413988 → UHC-59114-40 (Gary Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004230 | Orphan claim re-pointed Claims processor | CLM-425271 → UHC-11065-29 (Bruce Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004231 | Orphan claim re-pointed Claims processor | CLM-425844 → UHC-06395-75 (Noah Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004232 | Orphan claim re-pointed Claims processor | CLM-404365 → UHC-30752-12 (Marilyn Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004233 | Orphan claim re-pointed Claims processor | CLM-401868 → UHC-63167-30 (Nicholas Andrews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004234 | Orphan claim re-pointed Claims processor | CLM-420703 → UHC-72049-97 (Lauren Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004235 | Orphan claim re-pointed Claims processor | CLM-417869 → UHC-14155-80 (Heather Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004236 | Orphan claim re-pointed Claims processor | CLM-432272 → UHC-11474-59 (Richard Bishop) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004237 | Orphan claim re-pointed Claims processor | CLM-429551 → UHC-53608-54 (Anna Harvey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004238 | Orphan claim re-pointed Claims processor | CLM-421317 → UHC-24208-80 (Abigail Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004239 | Orphan claim re-pointed Claims processor | CLM-408009 → UHC-89912-98 (Joe Coleman) |
| 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.