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-006040 | Orphan claim re-pointed Claims processor | CLM-403799 → UHC-29346-52 (Jeffrey Allen) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006041 | Orphan claim re-pointed Claims processor | CLM-404565 → UHC-07836-36 (Michael Henry) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006042 | Orphan claim re-pointed Claims processor | CLM-400978 → UHC-70835-52 (Camila Rogers) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006043 | Orphan claim re-pointed Claims processor | CLM-407168 → UHC-13526-42 (Michelle Burke) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006044 | Orphan claim re-pointed Claims processor | CLM-406933 → UHC-52060-85 (Amber Delgado) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006045 | Orphan claim re-pointed Claims processor | CLM-429939 → UHC-39409-51 (Lauren Johnson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006046 | Orphan claim re-pointed Claims processor | CLM-409231 → UHC-74736-34 (Olivia Ramos) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006047 | Orphan claim re-pointed Claims processor | CLM-430561 → UHC-53849-60 (Stephanie Cox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006048 | Orphan claim re-pointed Claims processor | CLM-413360 → UHC-04677-70 (Ronald Padilla) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006049 | Orphan claim re-pointed Claims processor | CLM-427922 → UHC-68920-96 (Walter Duncan) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006050 | Orphan claim re-pointed Claims processor | CLM-404883 → UHC-49233-42 (Chapman Michael) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006051 | Orphan claim re-pointed Claims processor | CLM-429650 → UHC-48764-80 (Zachary Ellis) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006052 | Orphan claim re-pointed Claims processor | CLM-422786 → UHC-14805-65 (Eric Hunt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006053 | Orphan claim re-pointed Claims processor | CLM-426511 → UHC-12094-45 (Bryan Pena) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006054 | Orphan claim re-pointed Claims processor | CLM-424579 → UHC-37864-18 (Austin Bell) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006055 | Orphan claim re-pointed Claims processor | CLM-432156 → UHC-76846-41 (Kelly Gutierrez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006056 | Orphan claim re-pointed Claims processor | CLM-413462 → UHC-68471-33 (Matthew Fowler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006057 | Orphan claim re-pointed Claims processor | CLM-411408 → UHC-50056-60 (Nancy Castillo) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006058 | Orphan claim re-pointed Claims processor | CLM-418235 → UHC-90795-24 (Debra Hill) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006059 | Orphan claim re-pointed Claims processor | CLM-415597 → UHC-41853-46 (Ruth Hall) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006060 | Orphan claim re-pointed Claims processor | CLM-409561 → UHC-75955-49 (Elizabeth Olson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006061 | Orphan claim re-pointed Claims processor | CLM-428057 → UHC-10194-82 (Steven Matthews) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006062 | Orphan claim re-pointed Claims processor | CLM-429352 → UHC-55421-50 (Jeremy Dunn) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006063 | Orphan claim re-pointed Claims processor | CLM-403811 → UHC-44326-19 (Willie Lawrence) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006064 | Orphan claim re-pointed Claims processor | CLM-422675 → UHC-62501-64 (Wei Morris) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006065 | Orphan claim re-pointed Claims processor | CLM-416497 → UHC-35385-80 (Aisha Gibson) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006066 | Orphan claim re-pointed Claims processor | CLM-410251 → UHC-83567-23 (David Wheeler) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006067 | Orphan claim re-pointed Claims processor | CLM-431843 → UHC-72484-78 (Juan Williams) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006068 | Orphan claim re-pointed Claims processor | CLM-416313 → UHC-78882-41 (Kathleen Johnston) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006069 | Orphan claim re-pointed Claims processor | CLM-419357 → UHC-07141-01 (Wei Fuller) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006070 | Orphan claim re-pointed Claims processor | CLM-427546 → UHC-33142-39 (Joe Hicks) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006071 | Orphan claim re-pointed Claims processor | CLM-418489 → UHC-55488-72 (Bruce Sanchez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006072 | Orphan claim re-pointed Claims processor | CLM-430776 → UHC-10883-60 (Carol Cook) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006073 | Orphan claim re-pointed Claims processor | CLM-401563 → UHC-90730-92 (Richard Stewart) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006074 | Orphan claim re-pointed Claims processor | CLM-410939 → UHC-38545-58 (Ronald Patel) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006075 | Orphan claim re-pointed Claims processor | CLM-401246 → UHC-50329-53 (Aisha Holmes) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006076 | Orphan claim re-pointed Claims processor | CLM-429493 → UHC-27024-93 (Janet Crawford) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006077 | Orphan claim re-pointed Claims processor | CLM-424022 → UHC-58273-21 (Mike Contreras) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006078 | Orphan claim re-pointed Claims processor | CLM-431552 → UHC-73170-37 (Rebecca Payne) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006079 | Orphan claim re-pointed Claims processor | CLM-422903 → UHC-34570-63 (Mary Long) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006080 | Orphan claim re-pointed Claims processor | CLM-430313 → UHC-32544-49 (Sofia Bowman) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006081 | Orphan claim re-pointed Claims processor | CLM-411914 → UHC-68631-94 (Hannah Fox) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006082 | Orphan claim re-pointed Claims processor | CLM-408614 → UHC-25349-55 (Ralph Le) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006083 | Orphan claim re-pointed Claims processor | CLM-418697 → UHC-36004-77 (George Shaw) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006084 | Orphan claim re-pointed Claims processor | CLM-423004 → UHC-72599-06 (Julia Schmidt) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006085 | Orphan claim re-pointed Claims processor | CLM-402246 → UHC-09052-71 (Nathan Gilbert) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006086 | Orphan claim re-pointed Claims processor | CLM-400045 → UHC-49836-32 (Maria McCoy) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006087 | Orphan claim re-pointed Claims processor | CLM-417680 → UHC-72304-99 (Kevin Jimenez) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006088 | Orphan claim re-pointed Claims processor | CLM-414983 → UHC-50017-78 (Henry Gray) |
| Executed | resolution_agent 2026-10-22 12:47:23 | ||
| ACT-006089 | Orphan claim re-pointed Claims processor | CLM-411642 → UHC-63648-05 (Hiroshi Hamilton) |
| 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.