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
Eligibility conflict resolved, Eligibility engine, 1,339 proposed
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-000151 | Eligibility conflict resolved Eligibility engine | Carlos Salazar: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000152 | Eligibility conflict resolved Eligibility engine | Dick Jimenez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000153 | Eligibility conflict resolved Eligibility engine | Kevin Guerrero: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000154 | Eligibility conflict resolved Eligibility engine | Christina Guzman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000155 | Eligibility conflict resolved Eligibility engine | Robert Ford: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000156 | Eligibility conflict resolved Eligibility engine | Emma Pena: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000157 | Eligibility conflict resolved Eligibility engine | Melissa Henderson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000158 | Eligibility conflict resolved Eligibility engine | Cynthia Vazquez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000159 | Eligibility conflict resolved Eligibility engine | Pamela Arnold: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000160 | Eligibility conflict resolved Eligibility engine | Marilyn Romero: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000161 | Eligibility conflict resolved Eligibility engine | Nicole Gonzalez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000162 | Eligibility conflict resolved Eligibility engine | Justin Le: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000163 | Eligibility conflict resolved Eligibility engine | Yuki Meyer: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000164 | Eligibility conflict resolved Eligibility engine | Arjun Elliott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000165 | Eligibility conflict resolved Eligibility engine | Mari Matthews: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000166 | Eligibility conflict resolved Eligibility engine | Juan Welch: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000167 | Eligibility conflict resolved Eligibility engine | Emily Nguyen: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000168 | Eligibility conflict resolved Eligibility engine | Ana Gordon: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000169 | Eligibility conflict resolved Eligibility engine | Bryan Black: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000170 | Eligibility conflict resolved Eligibility engine | Joan Gonzales: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000171 | Eligibility conflict resolved Eligibility engine | Judy Delgado: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000172 | Eligibility conflict resolved Eligibility engine | Brian Larson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000173 | Eligibility conflict resolved Eligibility engine | Rachel Hughes: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000174 | Eligibility conflict resolved Eligibility engine | William Moreno: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000175 | Eligibility conflict resolved Eligibility engine | Cynthia Sandoval: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000176 | Eligibility conflict resolved Eligibility engine | Jonathan Gibson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000177 | Eligibility conflict resolved Eligibility engine | Theresa West: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000178 | Eligibility conflict resolved Eligibility engine | Lawrence Welch: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000179 | Eligibility conflict resolved Eligibility engine | Doris Brooks: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000180 | Eligibility conflict resolved Eligibility engine | Jean Williamson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000181 | Eligibility conflict resolved Eligibility engine | Brian Reid: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000182 | Eligibility conflict resolved Eligibility engine | Emma Meyer: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000183 | Eligibility conflict resolved Eligibility engine | Amy Flores: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000184 | Eligibility conflict resolved Eligibility engine | Ashley Watson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000185 | Eligibility conflict resolved Eligibility engine | Shirley Adams: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000186 | Eligibility conflict resolved Eligibility engine | Jeremy Reyes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000187 | Eligibility conflict resolved Eligibility engine | Camila Murphy: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000188 | Eligibility conflict resolved Eligibility engine | Carol Gutierrez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000189 | Eligibility conflict resolved Eligibility engine | Ana Jenkins: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000190 | Eligibility conflict resolved Eligibility engine | Scott Phillips: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000191 | Eligibility conflict resolved Eligibility engine | Sean Li: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000192 | Eligibility conflict resolved Eligibility engine | Eric Walker: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000193 | Eligibility conflict resolved Eligibility engine | Betty Walsh: 3 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000194 | Eligibility conflict resolved Eligibility engine | Virginia Harper: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000195 | Eligibility conflict resolved Eligibility engine | Olivia Gilbert: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000196 | Eligibility conflict resolved Eligibility engine | Brandon Herrera: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000197 | Eligibility conflict resolved Eligibility engine | Peter Alexander: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000198 | Eligibility conflict resolved Eligibility engine | Judith Ramirez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000199 | Eligibility conflict resolved Eligibility engine | Larry Banks: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000200 | Eligibility conflict resolved Eligibility engine | Christian Anderson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| 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.