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-005190 | Orphan claim re-pointed Claims processor | CLM-408358 → UHC-86549-94 (Jacqueline Yang) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005191 | Orphan claim re-pointed Claims processor | CLM-426043 → UHC-76267-15 (Sara Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005192 | Orphan claim re-pointed Claims processor | CLM-428046 → UHC-95060-50 (Roger Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005193 | Orphan claim re-pointed Claims processor | CLM-425287 → UHC-54583-90 (Ana Banks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005194 | Orphan claim re-pointed Claims processor | CLM-405743 → UHC-33507-96 (Victoria Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005195 | Orphan claim re-pointed Claims processor | CLM-423760 → UHC-58583-12 (Gutierrez Helen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005196 | Orphan claim re-pointed Claims processor | CLM-418602 → UHC-06049-09 (Marilyn Mason) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005197 | Orphan claim re-pointed Claims processor | CLM-428475 → UHC-60855-59 (Martha Black) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005198 | Orphan claim re-pointed Claims processor | CLM-429777 → UHC-92614-98 (Bruce Patterson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005199 | Orphan claim re-pointed Claims processor | CLM-404484 → UHC-79339-20 (Henry Anderson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005200 | Orphan claim re-pointed Claims processor | CLM-406105 → UHC-82611-55 (Vincent Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005201 | Orphan claim re-pointed Claims processor | CLM-409590 → UHC-00556-15 (Adam Turner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005202 | Orphan claim re-pointed Claims processor | CLM-418861 → UHC-02229-10 (Luis Knight) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005203 | Orphan claim re-pointed Claims processor | CLM-423016 → UHC-07292-09 (Jen Cooper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005204 | Orphan claim re-pointed Claims processor | CLM-432116 → UHC-38378-27 (Andrea Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005205 | Orphan claim re-pointed Claims processor | CLM-400072 → UHC-30893-25 (Camila Wagner) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005206 | Orphan claim re-pointed Claims processor | CLM-418600 → UHC-69380-61 (Deborah Simpson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005207 | Orphan claim re-pointed Claims processor | CLM-401958 → UHC-58974-57 (Charlotte Alexander) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005208 | Orphan claim re-pointed Claims processor | CLM-427503 → UHC-45751-58 (Wayne Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005209 | Orphan claim re-pointed Claims processor | CLM-413051 → UHC-48159-34 (Carolny Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005210 | Orphan claim re-pointed Claims processor | CLM-412703 → UHC-88524-21 (Brian Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005211 | Orphan claim re-pointed Claims processor | CLM-405500 → UHC-49365-80 (Alexis Howell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005212 | Orphan claim re-pointed Claims processor | CLM-401810 → UHC-69078-97 (Jacqueline Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005213 | Orphan claim re-pointed Claims processor | CLM-418743 → UHC-44354-85 (Jonathan Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005214 | Orphan claim re-pointed Claims processor | CLM-419541 → UHC-13791-50 (Charlotte Dixon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005215 | Orphan claim re-pointed Claims processor | CLM-402135 → UHC-05123-51 (Danielle Porter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005216 | Orphan claim re-pointed Claims processor | CLM-405478 → UHC-62597-73 (Mei Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005217 | Orphan claim re-pointed Claims processor | CLM-404415 → UHC-24401-43 (Janet Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005218 | Orphan claim re-pointed Claims processor | CLM-427227 → UHC-71794-95 (Michelle Soto) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005219 | Orphan claim re-pointed Claims processor | CLM-417243 → UHC-78000-99 (Joyce Santiago) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005220 | Orphan claim re-pointed Claims processor | CLM-408819 → UHC-04938-33 (Zachary Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005221 | Orphan claim re-pointed Claims processor | CLM-421661 → UHC-86333-10 (Heather Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005222 | Orphan claim re-pointed Claims processor | CLM-411271 → UHC-35079-82 (Stephanie Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005223 | Orphan claim re-pointed Claims processor | CLM-411015 → UHC-42385-49 (Brittany Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005224 | Orphan claim re-pointed Claims processor | CLM-429921 → UHC-23913-30 (Richard Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005225 | Orphan claim re-pointed Claims processor | CLM-420685 → UHC-74157-95 (Michael Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005226 | Orphan claim re-pointed Claims processor | CLM-417364 → UHC-08070-07 (Marcus Carpenter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005227 | Orphan claim re-pointed Claims processor | CLM-424763 → UHC-02610-34 (Grace Barnes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005228 | Orphan claim re-pointed Claims processor | CLM-426314 → UHC-46621-13 (Mark Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005229 | Orphan claim re-pointed Claims processor | CLM-424033 → UHC-45400-47 (Megan Kim) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005230 | Orphan claim re-pointed Claims processor | CLM-405677 → UHC-36092-77 (Barbara Hanson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005231 | Orphan claim re-pointed Claims processor | CLM-419375 → UHC-77634-20 (Jeffrey Wells) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005232 | Orphan claim re-pointed Claims processor | CLM-408244 → UHC-24383-41 (Valentina Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005233 | Orphan claim re-pointed Claims processor | CLM-421913 → UHC-40771-60 (Dylan White) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005234 | Orphan claim re-pointed Claims processor | CLM-420456 → UHC-27706-65 (Jennifer Watkins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005235 | Orphan claim re-pointed Claims processor | CLM-418344 → UHC-09522-48 (Carol Kelly) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005236 | Orphan claim re-pointed Claims processor | CLM-415091 → UHC-18514-12 (Daniel Reid) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005237 | Orphan claim re-pointed Claims processor | CLM-403527 → UHC-74052-85 (Terry Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005238 | Orphan claim re-pointed Claims processor | CLM-431900 → UHC-38371-52 (Margaret Fernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005239 | Orphan claim re-pointed Claims processor | CLM-413387 → UHC-80648-57 (Elijah Boyd) |
| 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.