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-004590 | Orphan claim re-pointed Claims processor | CLM-401052 → UHC-19364-47 (Rebecca Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004591 | Orphan claim re-pointed Claims processor | CLM-404914 → UHC-52819-86 (Austin Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004592 | Orphan claim re-pointed Claims processor | CLM-408913 → UHC-09600-88 (Theresa Morrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004593 | Orphan claim re-pointed Claims processor | CLM-402260 → UHC-39153-49 (Susan Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004594 | Orphan claim re-pointed Claims processor | CLM-423873 → UHC-26130-42 (Jennifer Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004595 | Orphan claim re-pointed Claims processor | CLM-412103 → UHC-25245-14 (Lawrence Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004596 | Orphan claim re-pointed Claims processor | CLM-405570 → UHC-86814-03 (Judy Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004597 | Orphan claim re-pointed Claims processor | CLM-400050 → UHC-53605-63 (Brenda Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004598 | Orphan claim re-pointed Claims processor | CLM-412277 → UHC-22875-45 (Catherine Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004599 | Orphan claim re-pointed Claims processor | CLM-415475 → UHC-91957-14 (Frank Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004600 | Orphan claim re-pointed Claims processor | CLM-416517 → UHC-15332-76 (Christian Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004601 | Orphan claim re-pointed Claims processor | CLM-425628 → UHC-57723-18 (Luis Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004602 | Orphan claim re-pointed Claims processor | CLM-415918 → UHC-84155-80 (Karen Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004603 | Orphan claim re-pointed Claims processor | CLM-415786 → UHC-34349-59 (Ana Diaz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004604 | Orphan claim re-pointed Claims processor | CLM-424395 → UHC-96841-08 (Donna Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004605 | Orphan claim re-pointed Claims processor | CLM-430099 → UHC-33373-43 (Nathan Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004606 | Orphan claim re-pointed Claims processor | CLM-426616 → UHC-42035-49 (Beverly Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004607 | Orphan claim re-pointed Claims processor | CLM-423989 → UHC-28027-27 (Randy Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004608 | Orphan claim re-pointed Claims processor | CLM-420310 → UHC-74147-24 (Sophia Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004609 | Orphan claim re-pointed Claims processor | CLM-411785 → UHC-19640-97 (Arjun Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004610 | Orphan claim re-pointed Claims processor | CLM-432299 → UHC-26938-12 (Laura Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004611 | Orphan claim re-pointed Claims processor | CLM-417515 → UHC-36962-36 (Gloria Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004612 | Orphan claim re-pointed Claims processor | CLM-413772 → UHC-52632-70 (Nathan Smith) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004613 | Orphan claim re-pointed Claims processor | CLM-425000 → UHC-99148-14 (Victoria Graham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004614 | Orphan claim re-pointed Claims processor | CLM-406943 → UHC-06520-75 (Priya Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004615 | Orphan claim re-pointed Claims processor | CLM-409349 → UHC-57072-21 (Matthew Romero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004616 | Orphan claim re-pointed Claims processor | CLM-420323 → UHC-57776-26 (Tucker Daniel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004617 | Orphan claim re-pointed Claims processor | CLM-404721 → UHC-99637-20 (Benjamin Morgen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004618 | Orphan claim re-pointed Claims processor | CLM-410599 → UHC-74026-83 (Paul Bailey) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004619 | Orphan claim re-pointed Claims processor | CLM-428691 → UHC-92720-51 (Lucia Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004620 | Orphan claim re-pointed Claims processor | CLM-415633 → UHC-94738-12 (Mei Wallace) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004621 | Orphan claim re-pointed Claims processor | CLM-411595 → UHC-89738-84 (Amanda Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004622 | Orphan claim re-pointed Claims processor | CLM-405461 → UHC-90340-61 (Jessica Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004623 | Orphan claim re-pointed Claims processor | CLM-419610 → UHC-02605-09 (Logan Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004624 | Orphan claim re-pointed Claims processor | CLM-424760 → UHC-28956-10 (Shirley Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004625 | Orphan claim re-pointed Claims processor | CLM-415682 → UHC-13873-93 (Michelle King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004626 | Orphan claim re-pointed Claims processor | CLM-425162 → UHC-04344-86 (Noah Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004627 | Orphan claim re-pointed Claims processor | CLM-429704 → UHC-09752-86 (Joshua Park) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004628 | Orphan claim re-pointed Claims processor | CLM-426191 → UHC-89652-89 (Rebecca Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004629 | Orphan claim re-pointed Claims processor | CLM-415380 → UHC-54040-20 (Kyle Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004630 | Orphan claim re-pointed Claims processor | CLM-401564 → UHC-59519-73 (Isabella Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004631 | Orphan claim re-pointed Claims processor | CLM-430389 → UHC-38492-32 (Keith Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004632 | Orphan claim re-pointed Claims processor | CLM-401755 → UHC-09575-01 (Juan Kennedy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004633 | Orphan claim re-pointed Claims processor | CLM-403308 → UHC-59675-28 (Hannah Mendoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004634 | Orphan claim re-pointed Claims processor | CLM-409974 → UHC-70041-90 (Tyler Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004635 | Orphan claim re-pointed Claims processor | CLM-427307 → UHC-55595-27 (Patricia Adams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004636 | Orphan claim re-pointed Claims processor | CLM-400039 → UHC-74188-59 (Logan Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004637 | Orphan claim re-pointed Claims processor | CLM-413341 → UHC-87948-44 (Samantha Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004638 | Orphan claim re-pointed Claims processor | CLM-413266 → UHC-19722-01 (Walter Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004639 | Orphan claim re-pointed Claims processor | CLM-423371 → UHC-43310-10 (Deborah Clark) |
| 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.