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-005490 | Orphan claim re-pointed Claims processor | CLM-417501 → UHC-24118-86 (Justin Reyes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005491 | Orphan claim re-pointed Claims processor | CLM-415183 → UHC-81209-58 (Kathryn Price) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005492 | Orphan claim re-pointed Claims processor | CLM-420263 → UHC-63051-72 (Martha Nichols) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005493 | Orphan claim re-pointed Claims processor | CLM-417247 → UHC-89202-61 (Russell Guerrero) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005494 | Orphan claim re-pointed Claims processor | CLM-419221 → UHC-90077-22 (Wayne Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005495 | Orphan claim re-pointed Claims processor | CLM-426788 → UHC-65062-39 (Christian Simmons) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005496 | Orphan claim re-pointed Claims processor | CLM-415535 → UHC-91234-39 (Kathryn Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005497 | Orphan claim re-pointed Claims processor | CLM-427067 → UHC-57083-46 (Sean Gordon) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005498 | Orphan claim re-pointed Claims processor | CLM-421480 → UHC-84578-81 (Bradley Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005499 | Orphan claim re-pointed Claims processor | CLM-411685 → UHC-00056-21 (Catherine Collins) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005500 | Orphan claim re-pointed Claims processor | CLM-420171 → UHC-49338-06 (Grace Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005501 | Orphan claim re-pointed Claims processor | CLM-414081 → UHC-94329-01 (Rchard Welch) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005502 | Orphan claim re-pointed Claims processor | CLM-409023 → UHC-86468-12 (Maria Hansen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005503 | Orphan claim re-pointed Claims processor | CLM-408661 → UHC-82658-64 (Stephen Ross) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005504 | Orphan claim re-pointed Claims processor | CLM-402999 → UHC-03857-67 (Bruce Jones) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005505 | Orphan claim re-pointed Claims processor | CLM-412570 → UHC-54449-78 (Noah Sims) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005506 | Orphan claim re-pointed Claims processor | CLM-408130 → UHC-87565-33 (Isabella Stephens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005507 | Orphan claim re-pointed Claims processor | CLM-412248 → UHC-95420-85 (Julie Sullivan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005508 | Orphan claim re-pointed Claims processor | CLM-417028 → UHC-96463-73 (Cheryl Thomas) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005509 | Orphan claim re-pointed Claims processor | CLM-426109 → UHC-89377-66 (Marcus Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005510 | Orphan claim re-pointed Claims processor | CLM-407436 → UHC-93836-27 (Carol Martinez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005511 | Orphan claim re-pointed Claims processor | CLM-412853 → UHC-02361-56 (Judith Vasquez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005512 | Orphan claim re-pointed Claims processor | CLM-417907 → UHC-03687-10 (Tricia Bradley) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005513 | Orphan claim re-pointed Claims processor | CLM-418070 → UHC-80886-56 (Kayla Perez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005514 | Orphan claim re-pointed Claims processor | CLM-421309 → UHC-39091-36 (Carol Rose) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005515 | Orphan claim re-pointed Claims processor | CLM-417187 → UHC-87854-09 (Julia Jackson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005516 | Orphan claim re-pointed Claims processor | CLM-406323 → UHC-19581-65 (Sara Carter) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005517 | Orphan claim re-pointed Claims processor | CLM-432769 → UHC-11191-55 (Margaret Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005518 | Orphan claim re-pointed Claims processor | CLM-409921 → UHC-51707-54 (Alexis Ruiz) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005519 | Orphan claim re-pointed Claims processor | CLM-402644 → UHC-52043-76 (Roy Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005520 | Orphan claim re-pointed Claims processor | CLM-422912 → UHC-80624-66 (Steven McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005521 | Orphan claim re-pointed Claims processor | CLM-424129 → UHC-61657-92 (Wei Stevens) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005522 | Orphan claim re-pointed Claims processor | CLM-431841 → UHC-72484-78 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005523 | Orphan claim re-pointed Claims processor | CLM-407000 → UHC-64753-11 (Megan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005524 | Orphan claim re-pointed Claims processor | CLM-417003 → UHC-69372-05 (Dylan Clark) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005525 | Orphan claim re-pointed Claims processor | CLM-405013 → UHC-78188-71 (Arthur Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005526 | Orphan claim re-pointed Claims processor | CLM-430560 → UHC-50821-50 (George Estrada) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005527 | Orphan claim re-pointed Claims processor | CLM-422373 → UHC-54681-25 (Jessica Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005528 | Orphan claim re-pointed Claims processor | CLM-430047 → UHC-24100-19 (Martha Powell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005529 | Orphan claim re-pointed Claims processor | CLM-408117 → UHC-79098-85 (Elijah Brown) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005530 | Orphan claim re-pointed Claims processor | CLM-428560 → UHC-51145-14 (Samuel Medina) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005531 | Orphan claim re-pointed Claims processor | CLM-431719 → UHC-22895-17 (Maria Armstrong) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005532 | Orphan claim re-pointed Claims processor | CLM-431625 → UHC-39693-44 (Bruce Harper) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005533 | Orphan claim re-pointed Claims processor | CLM-432153 → UHC-22051-95 (Denise Morales) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005534 | Orphan claim re-pointed Claims processor | CLM-419314 → UHC-78221-66 (Kayla McDonald) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005535 | Orphan claim re-pointed Claims processor | CLM-413417 → UHC-03506-53 (Bobby Miller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005536 | Orphan claim re-pointed Claims processor | CLM-429987 → UHC-06749-57 (Raymond Wood) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005537 | Orphan claim re-pointed Claims processor | CLM-405081 → UHC-83296-48 (Sofia Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005538 | Orphan claim re-pointed Claims processor | CLM-401227 → UHC-92472-25 (Danielle Young) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-005539 | Orphan claim re-pointed Claims processor | CLM-403588 → UHC-69793-41 (Bradley Wallace) |
| 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.