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-004240 | Orphan claim re-pointed Claims processor | CLM-427619 → UHC-49651-19 (Sarah Flores) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004241 | Orphan claim re-pointed Claims processor | CLM-403264 → UHC-51402-46 (Logan Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004242 | Orphan claim re-pointed Claims processor | CLM-425399 → UHC-43649-73 (Isabella Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004243 | Orphan claim re-pointed Claims processor | CLM-413623 → UHC-21997-61 (Eric Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004244 | Orphan claim re-pointed Claims processor | CLM-404717 → UHC-27674-38 (Sam Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004245 | Orphan claim re-pointed Claims processor | CLM-427835 → UHC-81335-37 (Roger Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004246 | Orphan claim re-pointed Claims processor | CLM-414226 → UHC-91421-44 (Patrick Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004247 | Orphan claim re-pointed Claims processor | CLM-410033 → UHC-91418-45 (Betty Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004248 | Orphan claim re-pointed Claims processor | CLM-418132 → UHC-68518-93 (Megan Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004249 | Orphan claim re-pointed Claims processor | CLM-410620 → UHC-53509-62 (Paul Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004250 | Orphan claim re-pointed Claims processor | CLM-424917 → UHC-29460-03 (Jack Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004251 | Orphan claim re-pointed Claims processor | CLM-413303 → UHC-20506-45 (Teresa Ford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004252 | Orphan claim re-pointed Claims processor | CLM-430914 → UHC-43468-04 (Justin Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004253 | Orphan claim re-pointed Claims processor | CLM-421986 → UHC-59702-59 (Kathleen Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004254 | Orphan claim re-pointed Claims processor | CLM-407131 → UHC-93569-57 (Bradley Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004255 | Orphan claim re-pointed Claims processor | CLM-413898 → UHC-71588-63 (Mason Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004256 | Orphan claim re-pointed Claims processor | CLM-421541 → UHC-53327-52 (Frances Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004257 | Orphan claim re-pointed Claims processor | CLM-427751 → UHC-31521-24 (Melissa Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004258 | Orphan claim re-pointed Claims processor | CLM-430855 → UHC-32148-92 (Russell Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004259 | Orphan claim re-pointed Claims processor | CLM-423283 → UHC-16726-86 (Elijah Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004260 | Orphan claim re-pointed Claims processor | CLM-421724 → UHC-75179-24 (Janice Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004261 | Orphan claim re-pointed Claims processor | CLM-422287 → UHC-73620-42 (Martha Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004262 | Orphan claim re-pointed Claims processor | CLM-427937 → UHC-95217-49 (Amber Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004263 | Orphan claim re-pointed Claims processor | CLM-427452 → UHC-34576-96 (Kathryn Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004264 | Orphan claim re-pointed Claims processor | CLM-418308 → UHC-60111-50 (Ethan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004265 | Orphan claim re-pointed Claims processor | CLM-411184 → UHC-81903-21 (Kelly Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004266 | Orphan claim re-pointed Claims processor | CLM-407311 → UHC-06864-83 (Christopher Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004267 | Orphan claim re-pointed Claims processor | CLM-424089 → UHC-20855-62 (Jack Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004268 | Orphan claim re-pointed Claims processor | CLM-404074 → UHC-11337-61 (Austin Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004269 | Orphan claim re-pointed Claims processor | CLM-419995 → UHC-55489-25 (Debra Coleman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004270 | Orphan claim re-pointed Claims processor | CLM-416209 → UHC-90213-48 (Barbara Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004271 | Orphan claim re-pointed Claims processor | CLM-410641 → UHC-71519-79 (Benjamin Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004272 | Orphan claim re-pointed Claims processor | CLM-419323 → UHC-96694-67 (Victoria Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004273 | Orphan claim re-pointed Claims processor | CLM-401953 → UHC-19536-68 (Justin Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004274 | Orphan claim re-pointed Claims processor | CLM-404431 → UHC-89708-54 (Jonathan Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004275 | Orphan claim re-pointed Claims processor | CLM-423164 → UHC-69639-21 (Austin Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004276 | Orphan claim re-pointed Claims processor | CLM-413496 → UHC-85408-43 (Logan Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004277 | Orphan claim re-pointed Claims processor | CLM-421107 → UHC-17765-89 (Dennis Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004278 | Orphan claim re-pointed Claims processor | CLM-432574 → UHC-89184-93 (Stephen West) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004279 | Orphan claim re-pointed Claims processor | CLM-417532 → UHC-30073-49 (Jeffrey Singh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004280 | Orphan claim re-pointed Claims processor | CLM-418725 → UHC-36257-71 (Ann Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004281 | Orphan claim re-pointed Claims processor | CLM-415233 → UHC-06757-59 (Betty Walsh) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004282 | Orphan claim re-pointed Claims processor | CLM-429107 → UHC-54344-81 (John Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004283 | Orphan claim re-pointed Claims processor | CLM-410037 → UHC-92120-58 (Joan Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004284 | Orphan claim re-pointed Claims processor | CLM-400825 → UHC-65773-86 (Victoria Jensen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004285 | Orphan claim re-pointed Claims processor | CLM-422547 → UHC-02051-22 (Pamela Tran) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004286 | Orphan claim re-pointed Claims processor | CLM-405953 → UHC-04052-21 (Carlos Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004287 | Orphan claim re-pointed Claims processor | CLM-425691 → UHC-86595-66 (Mei Maldonado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004288 | Orphan claim re-pointed Claims processor | CLM-426137 → UHC-68860-90 (Megan Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004289 | Orphan claim re-pointed Claims processor | CLM-432424 → UHC-20068-10 (Ronald Harrison) |
| 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.