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-005340 | Orphan claim re-pointed Claims processor | CLM-419061 → UHC-98920-26 (Donna Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005341 | Orphan claim re-pointed Claims processor | CLM-432278 → UHC-32126-41 (Teresa Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005342 | Orphan claim re-pointed Claims processor | CLM-415765 → UHC-11129-02 (Cheryl Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005343 | Orphan claim re-pointed Claims processor | CLM-401811 → UHC-69078-97 (Jacqueline Willis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005344 | Orphan claim re-pointed Claims processor | CLM-408624 → UHC-87112-20 (Diego Campbell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005345 | Orphan claim re-pointed Claims processor | CLM-422656 → UHC-24954-02 (Gary Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005346 | Orphan claim re-pointed Claims processor | CLM-410892 → UHC-47517-65 (Hiroshi Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005347 | Orphan claim re-pointed Claims processor | CLM-432758 → UHC-84285-56 (Adam Williamson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005348 | Orphan claim re-pointed Claims processor | CLM-416515 → UHC-75588-91 (Steven Jordan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005349 | Orphan claim re-pointed Claims processor | CLM-409484 → UHC-82032-35 (Margaret Stone) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005350 | Orphan claim re-pointed Claims processor | CLM-413323 → UHC-03845-70 (Eugene Webb) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005351 | Orphan claim re-pointed Claims processor | CLM-414257 → UHC-03691-68 (Ralph Green) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005352 | Orphan claim re-pointed Claims processor | CLM-427407 → UHC-09449-40 (Jeff Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005353 | Orphan claim re-pointed Claims processor | CLM-424605 → UHC-09027-77 (Frances Boyd) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005354 | Orphan claim re-pointed Claims processor | CLM-421043 → UHC-18091-41 (Emily Gonzalez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005355 | Orphan claim re-pointed Claims processor | CLM-421227 → UHC-02734-71 (Joan Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005356 | Orphan claim re-pointed Claims processor | CLM-423643 → UHC-08974-21 (Daniel Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005357 | Orphan claim re-pointed Claims processor | CLM-426728 → UHC-89508-38 (Jordan Moore) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005358 | Orphan claim re-pointed Claims processor | CLM-412002 → UHC-21780-50 (Joshua Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005359 | Orphan claim re-pointed Claims processor | CLM-417382 → UHC-17934-72 (Natalie Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005360 | Orphan claim re-pointed Claims processor | CLM-411360 → UHC-26940-05 (Julie Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005361 | Orphan claim re-pointed Claims processor | CLM-422956 → UHC-76265-13 (Kathleen Fisher) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005362 | Orphan claim re-pointed Claims processor | CLM-410157 → UHC-17351-28 (Joseph Hart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005363 | Orphan claim re-pointed Claims processor | CLM-412014 → UHC-62204-46 (Jerry Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005364 | Orphan claim re-pointed Claims processor | CLM-407582 → UHC-97436-25 (Robert Obrien) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005365 | Orphan claim re-pointed Claims processor | CLM-406482 → UHC-51488-43 (Logan Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005366 | Orphan claim re-pointed Claims processor | CLM-403398 → UHC-92193-29 (Jeremy Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005367 | Orphan claim re-pointed Claims processor | CLM-413875 → UHC-45394-30 (Christian Riiley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005368 | Orphan claim re-pointed Claims processor | CLM-424462 → UHC-31128-24 (Sara Oliver) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005369 | Orphan claim re-pointed Claims processor | CLM-409141 → UHC-27852-28 (Kelly Ferguson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005370 | Orphan claim re-pointed Claims processor | CLM-404547 → UHC-96000-34 (Teresa Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005371 | Orphan claim re-pointed Claims processor | CLM-413529 → UHC-81231-41 (Valentina Baker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005372 | Orphan claim re-pointed Claims processor | CLM-413022 → UHC-49553-83 (Julie Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005373 | Orphan claim re-pointed Claims processor | CLM-400979 → UHC-70835-52 (Camila Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005374 | Orphan claim re-pointed Claims processor | CLM-404551 → UHC-73800-42 (Patricia Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005375 | Orphan claim re-pointed Claims processor | CLM-413869 → UHC-40697-32 (Jacqueline Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005376 | Orphan claim re-pointed Claims processor | CLM-403770 → UHC-43670-05 (Kim Lee) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005377 | Orphan claim re-pointed Claims processor | CLM-401821 → UHC-64480-79 (Jonathan Rivera) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005378 | Orphan claim re-pointed Claims processor | CLM-417302 → UHC-26038-09 (Russell Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005379 | Orphan claim re-pointed Claims processor | CLM-429687 → UHC-75613-83 (Charles McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005380 | Orphan claim re-pointed Claims processor | CLM-430553 → UHC-30333-12 (Kimberly Evans) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005381 | Orphan claim re-pointed Claims processor | CLM-421072 → UHC-43983-84 (Mason Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005382 | Orphan claim re-pointed Claims processor | CLM-401253 → UHC-29310-13 (Carlos Scott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005383 | Orphan claim re-pointed Claims processor | CLM-421135 → UHC-72250-82 (Amber Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005384 | Orphan claim re-pointed Claims processor | CLM-413977 → UHC-24813-74 (Lisa Garrett) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005385 | Orphan claim re-pointed Claims processor | CLM-426579 → UHC-28952-82 (Ralph Kelley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005386 | Orphan claim re-pointed Claims processor | CLM-407024 → UHC-96213-84 (Yuki Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005387 | Orphan claim re-pointed Claims processor | CLM-413792 → UHC-19461-15 (Denise Ortega) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005388 | Orphan claim re-pointed Claims processor | CLM-421923 → UHC-34912-88 (Theresa Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005389 | Orphan claim re-pointed Claims processor | CLM-411373 → UHC-54013-72 (Gregory Salazar) |
| 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.