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-004640 | Orphan claim re-pointed Claims processor | CLM-422511 → UHC-75523-93 (Joseph Hamilton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004641 | Orphan claim re-pointed Claims processor | CLM-415648 → UHC-79616-93 (Arthur Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004642 | Orphan claim re-pointed Claims processor | CLM-414521 → UHC-46817-61 (Mateo Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004643 | Orphan claim re-pointed Claims processor | CLM-418486 → UHC-92698-48 (Martha Haimlton) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004644 | Orphan claim re-pointed Claims processor | CLM-408842 → UHC-62451-86 (Berb Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004645 | Orphan claim re-pointed Claims processor | CLM-415807 → UHC-39950-19 (Karen Woods) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004646 | Orphan claim re-pointed Claims processor | CLM-418487 → UHC-29960-66 (Julia Perkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004647 | Orphan claim re-pointed Claims processor | CLM-412584 → UHC-95902-92 (Richard Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004648 | Orphan claim re-pointed Claims processor | CLM-406572 → UHC-69881-24 (Jean Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004649 | Orphan claim re-pointed Claims processor | CLM-413507 → UHC-05207-17 (Scott Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004650 | Orphan claim re-pointed Claims processor | CLM-431068 → UHC-71496-81 (Aleexander Reed) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004651 | Orphan claim re-pointed Claims processor | CLM-416192 → UHC-72425-74 (Steven Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004652 | Orphan claim re-pointed Claims processor | CLM-401601 → UHC-20395-46 (Michelle Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004653 | Orphan claim re-pointed Claims processor | CLM-410565 → UHC-15160-88 (Sean Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004654 | Orphan claim re-pointed Claims processor | CLM-402140 → UHC-32734-85 (Bruce Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004655 | Orphan claim re-pointed Claims processor | CLM-421164 → UHC-52984-88 (Bradley Foster) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004656 | Orphan claim re-pointed Claims processor | CLM-421849 → UHC-40826-72 (Charles Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004657 | Orphan claim re-pointed Claims processor | CLM-418328 → UHC-29058-11 (Hannah Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004658 | Orphan claim re-pointed Claims processor | CLM-405819 → UHC-02231-81 (Justin Hawkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004659 | Orphan claim re-pointed Claims processor | CLM-410698 → UHC-84467-90 (Brandon Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004660 | Orphan claim re-pointed Claims processor | CLM-408257 → UHC-44075-82 (Wayne Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004661 | Orphan claim re-pointed Claims processor | CLM-420320 → UHC-80809-16 (Isabella Garza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004662 | Orphan claim re-pointed Claims processor | CLM-407857 → UHC-88715-46 (Ronald Espinoza) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004663 | Orphan claim re-pointed Claims processor | CLM-428049 → UHC-03263-23 (Evelyn Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004664 | Orphan claim re-pointed Claims processor | CLM-417001 → UHC-38087-84 (Daniel Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004665 | Orphan claim re-pointed Claims processor | CLM-401823 → UHC-19090-03 (Cynthia Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004666 | Orphan claim re-pointed Claims processor | CLM-400703 → UHC-32789-06 (Ethan Vargas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004667 | Orphan claim re-pointed Claims processor | CLM-427711 → UHC-66153-39 (Carol Brooks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004668 | Orphan claim re-pointed Claims processor | CLM-423228 → UHC-33176-99 (Joyce Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004669 | Orphan claim re-pointed Claims processor | CLM-411104 → UHC-05848-56 (Hannah Silva) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004670 | Orphan claim re-pointed Claims processor | CLM-410562 → UHC-78828-86 (Kyle Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004671 | Orphan claim re-pointed Claims processor | CLM-418963 → UHC-23434-82 (Yuki Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004672 | Orphan claim re-pointed Claims processor | CLM-430320 → UHC-98462-27 (Joyce Santos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004673 | Orphan claim re-pointed Claims processor | CLM-412091 → UHC-37396-05 (Judith Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004674 | Orphan claim re-pointed Claims processor | CLM-400320 → UHC-81351-96 (Edward Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004675 | Orphan claim re-pointed Claims processor | CLM-424374 → UHC-86900-82 (Bowman Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004676 | Orphan claim re-pointed Claims processor | CLM-400939 → UHC-11754-69 (Roger Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004677 | Orphan claim re-pointed Claims processor | CLM-406554 → UHC-78882-43 (Evelyn Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004678 | Orphan claim re-pointed Claims processor | CLM-401133 → UHC-91989-12 (Diana Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004679 | Orphan claim re-pointed Claims processor | CLM-431330 → UHC-60495-13 (Harold Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004680 | Orphan claim re-pointed Claims processor | CLM-403036 → UHC-60766-67 (Patricia Ray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004681 | Orphan claim re-pointed Claims processor | CLM-401112 → UHC-20583-29 (Jeff Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004682 | Orphan claim re-pointed Claims processor | CLM-417152 → UHC-78337-47 (Timothy Wong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004683 | Orphan claim re-pointed Claims processor | CLM-407243 → UHC-87494-19 (Vincent Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004684 | Orphan claim re-pointed Claims processor | CLM-404154 → UHC-47212-39 (Olivia Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004685 | Orphan claim re-pointed Claims processor | CLM-404416 → UHC-34937-60 (Alan Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004686 | Orphan claim re-pointed Claims processor | CLM-429651 → UHC-97105-20 (Timothy Ward) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004687 | Orphan claim re-pointed Claims processor | CLM-425914 → UHC-60558-56 (Ruth Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004688 | Orphan claim re-pointed Claims processor | CLM-414860 → UHC-90304-33 (Nancy Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004689 | Orphan claim re-pointed Claims processor | CLM-414830 → UHC-12213-45 (Grace 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.