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 suppressed
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
Orphan claim re-pointed, Claims processor, 0 proposed
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-001340 | Orphan claim re-pointed Claims processor | CLM-403288 → UHC-81817-78 (Shirley Harvey) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001341 | Orphan claim re-pointed Claims processor | CLM-409453 → UHC-06553-73 (Pamela Yang) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001342 | Orphan claim re-pointed Claims processor | CLM-415528 → UHC-11930-34 (Amy Wright) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001343 | Orphan claim re-pointed Claims processor | CLM-414432 → UHC-15556-78 (Justin Snyder) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001344 | Orphan claim re-pointed Claims processor | CLM-429901 → UHC-05517-87 (Mark Nelson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001345 | Orphan claim re-pointed Claims processor | CLM-428305 → UHC-63351-43 (Jerry Perkins) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001346 | Orphan claim re-pointed Claims processor | CLM-400406 → UHC-06862-81 (Aaron Harper) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001347 | Orphan claim re-pointed Claims processor | CLM-421183 → UHC-18725-71 (Gary Guerrero) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001348 | Orphan claim re-pointed Claims processor | CLM-427685 → UHC-22892-68 (Jesse Peterson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001349 | Orphan claim re-pointed Claims processor | CLM-420295 → UHC-17734-66 (Susan Jackson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001350 | Orphan claim re-pointed Claims processor | CLM-416029 → UHC-03400-57 (Lori Gibson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001351 | Orphan claim re-pointed Claims processor | CLM-423678 → UHC-38974-87 (Adam Griffin) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001352 | Orphan claim re-pointed Claims processor | CLM-407989 → UHC-37140-99 (Camila Sims) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001353 | Orphan claim re-pointed Claims processor | CLM-402703 → UHC-55663-84 (Donna Russell) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001354 | Orphan claim re-pointed Claims processor | CLM-407140 → UHC-71190-27 (Alice Spencer) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001355 | Orphan claim re-pointed Claims processor | CLM-419476 → UHC-37209-76 (Olivia Dunn) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001356 | Orphan claim re-pointed Claims processor | CLM-411580 → UHC-39070-93 (Samuel Williamson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001357 | Orphan claim re-pointed Claims processor | CLM-401561 → UHC-59698-55 (Jessica Elllis) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001358 | Orphan claim re-pointed Claims processor | CLM-418488 → UHC-29960-66 (Julia Perkins) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001359 | Orphan claim re-pointed Claims processor | CLM-423756 → UHC-90029-18 (Bradley Hughes) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001360 | Orphan claim re-pointed Claims processor | CLM-404732 → UHC-96679-77 (Ann Cook) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001361 | Orphan claim re-pointed Claims processor | CLM-424375 → UHC-86900-82 (Bowman Bowman) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001362 | Orphan claim re-pointed Claims processor | CLM-412946 → UHC-66079-97 (Kyle Phillips) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001363 | Orphan claim re-pointed Claims processor | CLM-419172 → UHC-76600-57 (Frank Ramos) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001364 | Orphan claim re-pointed Claims processor | CLM-403733 → UHC-96431-19 (Kathryn Wang) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001365 | Orphan claim re-pointed Claims processor | CLM-404402 → UHC-87281-93 (Lisa Campbell) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001366 | Orphan claim re-pointed Claims processor | CLM-407293 → UHC-64583-03 (Kimberly White) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001367 | Orphan claim re-pointed Claims processor | CLM-411602 → UHC-53647-10 (Amanda Hansen) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001368 | Orphan claim re-pointed Claims processor | CLM-428002 → UHC-38530-83 (Helen Garcia) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001369 | Orphan claim re-pointed Claims processor | CLM-405400 → UHC-42573-34 (Marilyn Nguyen) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001370 | Orphan claim re-pointed Claims processor | CLM-408369 → UHC-54625-23 (Mason Maldonado) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001371 | Orphan claim re-pointed Claims processor | CLM-400741 → UHC-19865-62 (Adam Simpson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001372 | Orphan claim re-pointed Claims processor | CLM-410015 → UHC-48577-49 (Noah Estrada) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001373 | Orphan claim re-pointed Claims processor | CLM-428649 → UHC-61970-31 (Mason Arnold) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001374 | Orphan claim re-pointed Claims processor | CLM-416854 → UHC-92808-15 (Jeffrey Mendoza) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001375 | Orphan claim re-pointed Claims processor | CLM-408400 → UHC-92935-47 (Anthony Henderson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001376 | Orphan claim re-pointed Claims processor | CLM-406632 → UHC-85810-37 (Joe Stephens) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001377 | Orphan claim re-pointed Claims processor | CLM-409676 → UHC-56059-24 (Margaret Hernandez) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001378 | Orphan claim re-pointed Claims processor | CLM-422325 → UHC-48780-72 (Lawrence Fox) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001379 | Orphan claim re-pointed Claims processor | CLM-421134 → UHC-72250-82 (Amber Larson) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001380 | Orphan claim re-pointed Claims processor | CLM-409693 → UHC-54667-79 (Christian Woods) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001381 | Orphan claim re-pointed Claims processor | CLM-408783 → UHC-30243-38 (Eugene Arnold) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001382 | Orphan claim re-pointed Claims processor | CLM-403734 → UHC-78358-58 (Gabriel Gonzalez) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001383 | Orphan claim re-pointed Claims processor | CLM-403786 → UHC-28452-62 (Walter Luna) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001384 | Orphan claim re-pointed Claims processor | CLM-416622 → UHC-22905-01 (Wayne Bailey) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001385 | Orphan claim re-pointed Claims processor | CLM-415138 → UHC-25372-81 (Mei Jordan) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001386 | Orphan claim re-pointed Claims processor | CLM-413215 → UHC-76989-44 (Albert Mendez) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001387 | Orphan claim re-pointed Claims processor | CLM-401686 → UHC-16393-73 (Bryan Walsh) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001388 | Orphan claim re-pointed Claims processor | CLM-414628 → UHC-70988-35 (Alan Ellis) |
| Executed | resolution_agent 2026-10-21 12:38:40 | ||
| ACT-001389 | Orphan claim re-pointed Claims processor | CLM-412467 → UHC-25813-01 (Alexis Watkins) |
| Executed | resolution_agent 2026-10-21 12:38:40 |
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.