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-000001 | Eligibility conflict resolved Eligibility engine | Willie Martin: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000002 | Eligibility conflict resolved Eligibility engine | Marilyn Rojas: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000003 | Eligibility conflict resolved Eligibility engine | Camila Webb: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000004 | Eligibility conflict resolved Eligibility engine | Timothy Brown: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000005 | Eligibility conflict resolved Eligibility engine | Sara Baker: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000006 | Eligibility conflict resolved Eligibility engine | Ethan Jackson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000007 | Eligibility conflict resolved Eligibility engine | Diana Reid: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000008 | Eligibility conflict resolved Eligibility engine | Tyler Ramirez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000009 | Eligibility conflict resolved Eligibility engine | Amber Lee: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000010 | Eligibility conflict resolved Eligibility engine | Jean Wang: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000011 | Eligibility conflict resolved Eligibility engine | Henry Hunter: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000012 | Eligibility conflict resolved Eligibility engine | Amanda Bennett: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000013 | Eligibility conflict resolved Eligibility engine | Christina Olson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000014 | Eligibility conflict resolved Eligibility engine | Jose Barnes: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000015 | Eligibility conflict resolved Eligibility engine | James Stewart: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000016 | Eligibility conflict resolved Eligibility engine | Thomas Snyder: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000017 | Eligibility conflict resolved Eligibility engine | Hiroshi Vazquez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000018 | Eligibility conflict resolved Eligibility engine | Susan Garrett: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000019 | Eligibility conflict resolved Eligibility engine | Philip Carpenter: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000020 | Eligibility conflict resolved Eligibility engine | Daniel Larson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000021 | Eligibility conflict resolved Eligibility engine | Jeffrey Myers: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000022 | Eligibility conflict resolved Eligibility engine | Gary Espinoza: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000023 | Eligibility conflict resolved Eligibility engine | Willie Garcia: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000024 | Eligibility conflict resolved Eligibility engine | Jean Pena: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000025 | Eligibility conflict resolved Eligibility engine | Ann Adams: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000026 | Eligibility conflict resolved Eligibility engine | Jacqueline Burke: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000027 | Eligibility conflict resolved Eligibility engine | Lisa Morales: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000028 | Eligibility conflict resolved Eligibility engine | Tyler Rojas: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000029 | Eligibility conflict resolved Eligibility engine | Christine Morgan: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000030 | Eligibility conflict resolved Eligibility engine | Doris Garrett: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000031 | Eligibility conflict resolved Eligibility engine | Susan Ward: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000032 | Eligibility conflict resolved Eligibility engine | Jessica Vargas: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000033 | Eligibility conflict resolved Eligibility engine | Nicole Snyder: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000034 | Eligibility conflict resolved Eligibility engine | Nancy Bishop: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000035 | Eligibility conflict resolved Eligibility engine | Zachary Bryant: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000036 | Eligibility conflict resolved Eligibility engine | Omar Ortiz: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000037 | Eligibility conflict resolved Eligibility engine | Nicole Riley: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000038 | Eligibility conflict resolved Eligibility engine | Danielle King: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000039 | Eligibility conflict resolved Eligibility engine | Julia Carlson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000040 | Eligibility conflict resolved Eligibility engine | Diego Contreras: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000041 | Eligibility conflict resolved Eligibility engine | Ralph Graham: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000042 | Eligibility conflict resolved Eligibility engine | Judith Maldonado: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000043 | Eligibility conflict resolved Eligibility engine | Kimberly Dixon: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000044 | Eligibility conflict resolved Eligibility engine | Grace Little: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000045 | Eligibility conflict resolved Eligibility engine | Adam Burns: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000046 | Eligibility conflict resolved Eligibility engine | Jerry Anderson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000047 | Eligibility conflict resolved Eligibility engine | Christopher Thomas: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000048 | Eligibility conflict resolved Eligibility engine | Sandra White: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000049 | Eligibility conflict resolved Eligibility engine | Sean Berry: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000050 | Eligibility conflict resolved Eligibility engine | Kyle Contreras: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — |
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.