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-005440 | Orphan claim re-pointed Claims processor | CLM-426066 → UHC-91411-90 (Charles Tucker) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005441 | Orphan claim re-pointed Claims processor | CLM-424254 → UHC-36916-85 (Beverly Butler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005442 | Orphan claim re-pointed Claims processor | CLM-412958 → UHC-47131-54 (Dylan Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005443 | Orphan claim re-pointed Claims processor | CLM-419817 → UHC-77204-58 (Doris Elliott) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005444 | Orphan claim re-pointed Claims processor | CLM-427818 → UHC-77908-77 (Camila Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005445 | Orphan claim re-pointed Claims processor | CLM-403277 → UHC-17614-53 (Harold Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005446 | Orphan claim re-pointed Claims processor | CLM-415483 → UHC-25673-02 (Diego Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005447 | Orphan claim re-pointed Claims processor | CLM-421544 → UHC-22001-33 (Megan Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005448 | Orphan claim re-pointed Claims processor | CLM-414200 → UHC-77438-22 (Mari Larson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005449 | Orphan claim re-pointed Claims processor | CLM-432416 → UHC-35325-16 (Jacob Rojas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005450 | Orphan claim re-pointed Claims processor | CLM-410078 → UHC-03599-81 (Lisa Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005451 | Orphan claim re-pointed Claims processor | CLM-413945 → UHC-34110-11 (Mason Rios) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005452 | Orphan claim re-pointed Claims processor | CLM-411844 → UHC-86550-30 (Patrick Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005453 | Orphan claim re-pointed Claims processor | CLM-403018 → UHC-61543-39 (Nancy Vazquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005454 | Orphan claim re-pointed Claims processor | CLM-419287 → UHC-90566-07 (Marilyn Carr) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005455 | Orphan claim re-pointed Claims processor | CLM-400129 → UHC-57472-02 (William Dean) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005456 | Orphan claim re-pointed Claims processor | CLM-410846 → UHC-45064-52 (Laura Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005457 | Orphan claim re-pointed Claims processor | CLM-413841 → UHC-77457-34 (Austin Nelson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005458 | Orphan claim re-pointed Claims processor | CLM-400201 → UHC-26091-54 (Roger Ortiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005459 | Orphan claim re-pointed Claims processor | CLM-411083 → UHC-73884-55 (Gabriel Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005460 | Orphan claim re-pointed Claims processor | CLM-424362 → UHC-15386-32 (Pamela Hayes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005461 | Orphan claim re-pointed Claims processor | CLM-412048 → UHC-59354-09 (Laryr Lawson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005462 | Orphan claim re-pointed Claims processor | CLM-418654 → UHC-62081-02 (Maria Gonzales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005463 | Orphan claim re-pointed Claims processor | CLM-408196 → UHC-56453-10 (Kelly Harris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005464 | Orphan claim re-pointed Claims processor | CLM-407113 → UHC-76710-68 (Katherine Hernandez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005465 | Orphan claim re-pointed Claims processor | CLM-419584 → UHC-23309-57 (Jesse Harrison) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005466 | Orphan claim re-pointed Claims processor | CLM-418717 → UHC-31272-97 (Jason Watson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005467 | Orphan claim re-pointed Claims processor | CLM-423593 → UHC-72123-01 (Rebecca Rodriguez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005468 | Orphan claim re-pointed Claims processor | CLM-400590 → UHC-96079-84 (Kathleen Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005469 | Orphan claim re-pointed Claims processor | CLM-408476 → UHC-08239-66 (Eric Castro) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005470 | Orphan claim re-pointed Claims processor | CLM-411460 → UHC-57349-54 (Carl Montgomery) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005471 | Orphan claim re-pointed Claims processor | CLM-408820 → UHC-04938-33 (Zachary Hudson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005472 | Orphan claim re-pointed Claims processor | CLM-402221 → UHC-52893-38 (Kimberly Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005473 | Orphan claim re-pointed Claims processor | CLM-430008 → UHC-97637-81 (Jacqueline Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005474 | Orphan claim re-pointed Claims processor | CLM-408873 → UHC-71648-01 (Helen Washington) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005475 | Orphan claim re-pointed Claims processor | CLM-410617 → UHC-31632-29 (Ronald Sanders) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005476 | Orphan claim re-pointed Claims processor | CLM-421773 → UHC-12314-12 (Luis McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005477 | Orphan claim re-pointed Claims processor | CLM-407587 → UHC-32673-49 (Charles Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005478 | Orphan claim re-pointed Claims processor | CLM-403401 → UHC-28801-38 (Amanda Cole) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005479 | Orphan claim re-pointed Claims processor | CLM-420749 → UHC-72641-27 (Laura Little) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005480 | Orphan claim re-pointed Claims processor | CLM-424622 → UHC-01081-09 (Jack Austin) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005481 | Orphan claim re-pointed Claims processor | CLM-431152 → UHC-45378-23 (Jordan Munoz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005482 | Orphan claim re-pointed Claims processor | CLM-429476 → UHC-65430-50 (Megan Mejia) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005483 | Orphan claim re-pointed Claims processor | CLM-400379 → UHC-39117-66 (Vicky Lynch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005484 | Orphan claim re-pointed Claims processor | CLM-406645 → UHC-24696-32 (Denise King) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005485 | Orphan claim re-pointed Claims processor | CLM-413941 → UHC-01330-32 (Albert Marshall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005486 | Orphan claim re-pointed Claims processor | CLM-411994 → UHC-06277-65 (Maria Hoffman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005487 | Orphan claim re-pointed Claims processor | CLM-410052 → UHC-88337-04 (Peter Myers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005488 | Orphan claim re-pointed Claims processor | CLM-423406 → UHC-89016-23 (Philip Arnold) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005489 | Orphan claim re-pointed Claims processor | CLM-416932 → UHC-57453-86 (Stephen Stevens) |
| 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.