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-004740 | Orphan claim re-pointed Claims processor | CLM-420950 → UHC-28875-07 (Hiroshi Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004741 | Orphan claim re-pointed Claims processor | CLM-414775 → UHC-96890-16 (Carol Peters) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004742 | Orphan claim re-pointed Claims processor | CLM-425773 → UHC-21911-64 (Joan Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004743 | Orphan claim re-pointed Claims processor | CLM-418039 → UHC-23021-94 (Sofia Richards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004744 | Orphan claim re-pointed Claims processor | CLM-432798 → UHC-04979-01 (Albert Perry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004745 | Orphan claim re-pointed Claims processor | CLM-420823 → UHC-90013-58 (Logan Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004746 | Orphan claim re-pointed Claims processor | CLM-404949 → UHC-22461-47 (Nicole Rice) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004747 | Orphan claim re-pointed Claims processor | CLM-414439 → UHC-47895-75 (Teresa Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004748 | Orphan claim re-pointed Claims processor | CLM-426344 → UHC-71491-85 (Omar Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004749 | Orphan claim re-pointed Claims processor | CLM-410916 → UHC-81632-20 (Teresa Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004750 | Orphan claim re-pointed Claims processor | CLM-401598 → UHC-21240-90 (Brandon Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004751 | Orphan claim re-pointed Claims processor | CLM-422144 → UHC-88614-34 (Joan Edwards) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004752 | Orphan claim re-pointed Claims processor | CLM-402279 → UHC-73386-28 (Vincent Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004753 | Orphan claim re-pointed Claims processor | CLM-407997 → UHC-20499-93 (Angela Salazar) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004754 | Orphan claim re-pointed Claims processor | CLM-413007 → UHC-76555-39 (Camila Weaver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004755 | Orphan claim re-pointed Claims processor | CLM-400947 → UHC-10546-53 (Amy Torres) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004756 | Orphan claim re-pointed Claims processor | CLM-420974 → UHC-83917-22 (Angela Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004757 | Orphan claim re-pointed Claims processor | CLM-419867 → UHC-54865-20 (Sanitago Franklin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004758 | Orphan claim re-pointed Claims processor | CLM-408688 → UHC-77500-44 (Evelyn Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004759 | Orphan claim re-pointed Claims processor | CLM-431638 → UHC-72009-07 (Melissa Weber) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004760 | Orphan claim re-pointed Claims processor | CLM-403641 → UHC-74959-06 (Wells Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004761 | Orphan claim re-pointed Claims processor | CLM-411098 → UHC-90440-20 (Roger Robertson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004762 | Orphan claim re-pointed Claims processor | CLM-429854 → UHC-22640-29 (Amanda Phillips) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004763 | Orphan claim re-pointed Claims processor | CLM-409576 → UHC-33964-15 (Heather Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004764 | Orphan claim re-pointed Claims processor | CLM-414633 → UHC-11790-26 (Kelly Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004765 | Orphan claim re-pointed Claims processor | CLM-405895 → UHC-78188-24 (Debra Greene) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004766 | Orphan claim re-pointed Claims processor | CLM-419277 → UHC-11444-52 (Diane Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004767 | Orphan claim re-pointed Claims processor | CLM-429968 → UHC-84734-28 (Arjun Jackkson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004768 | Orphan claim re-pointed Claims processor | CLM-402518 → UHC-68529-89 (Ethan Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004769 | Orphan claim re-pointed Claims processor | CLM-407468 → UHC-02582-56 (Christian Reynolds) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004770 | Orphan claim re-pointed Claims processor | CLM-427088 → UHC-39366-98 (James Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004771 | Orphan claim re-pointed Claims processor | CLM-419421 → UHC-45305-19 (Sharon Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004772 | Orphan claim re-pointed Claims processor | CLM-410369 → UHC-25525-72 (Aaron Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004773 | Orphan claim re-pointed Claims processor | CLM-415227 → UHC-63802-23 (Robert Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004774 | Orphan claim re-pointed Claims processor | CLM-408887 → UHC-13959-33 (Lawrence Wrihgt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004775 | Orphan claim re-pointed Claims processor | CLM-426201 → UHC-47553-11 (Roy Wilson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004776 | Orphan claim re-pointed Claims processor | CLM-418676 → UHC-77633-66 (Tyler Parker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004777 | Orphan claim re-pointed Claims processor | CLM-425957 → UHC-38146-61 (Kevin Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004778 | Orphan claim re-pointed Claims processor | CLM-409494 → UHC-14810-76 (Nathan Cunningham) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004779 | Orphan claim re-pointed Claims processor | CLM-415253 → UHC-16904-99 (Ralph Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004780 | Orphan claim re-pointed Claims processor | CLM-432716 → UHC-06936-55 (Randy Riley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004781 | Orphan claim re-pointed Claims processor | CLM-420357 → UHC-14793-72 (Douglas Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004782 | Orphan claim re-pointed Claims processor | CLM-431553 → UHC-73170-37 (Rebecca Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004783 | Orphan claim re-pointed Claims processor | CLM-430804 → UHC-14233-10 (Kyle Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004784 | Orphan claim re-pointed Claims processor | CLM-406966 → UHC-40110-94 (Laura Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004785 | Orphan claim re-pointed Claims processor | CLM-411725 → UHC-06365-30 (Melissa Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004786 | Orphan claim re-pointed Claims processor | CLM-428540 → UHC-66312-14 (Megan Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004787 | Orphan claim re-pointed Claims processor | CLM-419487 → UHC-42918-02 (Judith Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004788 | Orphan claim re-pointed Claims processor | CLM-428360 → UHC-69403-78 (Willie Chen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-004789 | Orphan claim re-pointed Claims processor | CLM-426793 → UHC-66958-89 (Kenneth Washington) |
| 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.