Action	Type	Title	Detail	Linked to	Status	Executed
ACT-019371	Care coordination outreach Next-best-action	Patricia Wood: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027385	Proposed	—
ACT-019372	Care coordination outreach Next-best-action	Angela George: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027401	Proposed	—
ACT-019373	Care coordination outreach Next-best-action	Isabella McDonald: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027404	Proposed	—
ACT-019374	Care coordination outreach Next-best-action	Margaret Obrien: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-027484	Proposed	—
ACT-019375	Care coordination outreach Next-best-action	Brittany Romero: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027504	Proposed	—
ACT-019376	Care coordination outreach Next-best-action	Mariana Parker: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027522	Proposed	—
ACT-019377	Care coordination outreach Next-best-action	Nathan Powell: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-027531	Proposed	—
ACT-019378	Care coordination outreach Next-best-action	Jessica Sanchez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027572	Proposed	—
ACT-019379	Care coordination outreach Next-best-action	Frances George: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027591	Proposed	—
ACT-019380	Care coordination outreach Next-best-action	Michelle Nelson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027654	Proposed	—
ACT-019381	Care coordination outreach Next-best-action	Joseph Wheeler: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-027694	Proposed	—
ACT-019382	Care coordination outreach Next-best-action	Rachel Davis: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027730	Proposed	—
ACT-019383	Care coordination outreach Next-best-action	Omar Boyd: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027759	Proposed	—
ACT-019384	Care coordination outreach Next-best-action	Rebecca Kennedy: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-027769	Proposed	—
ACT-019385	Care coordination outreach Next-best-action	Peter Smith: 5 claims, no attributed provider	Claims 5 Recommendation assign PCP and schedule care-coordination call	MBR-027791	Proposed	—
ACT-019386	Care coordination outreach Next-best-action	Joseph Henderson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027796	Proposed	—
ACT-019387	Care coordination outreach Next-best-action	Albert Lynch: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027805	Proposed	—
ACT-019388	Care coordination outreach Next-best-action	Elijah Torres: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027806	Proposed	—
ACT-019389	Care coordination outreach Next-best-action	Christina Nguyen: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027856	Proposed	—
ACT-019390	Care coordination outreach Next-best-action	Zachary Hudson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027874	Proposed	—
ACT-019391	Care coordination outreach Next-best-action	James Rojas: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027880	Proposed	—
ACT-019392	Care coordination outreach Next-best-action	Donald Adams: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027904	Proposed	—
ACT-019393	Care coordination outreach Next-best-action	Adam Vega: 5 claims, no attributed provider	Claims 5 Recommendation assign PCP and schedule care-coordination call	MBR-027921	Proposed	—
ACT-019394	Care coordination outreach Next-best-action	Joan Meyer: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027940	Proposed	—
ACT-019395	Care coordination outreach Next-best-action	Joyce Duncan: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027942	Proposed	—
ACT-019396	Care coordination outreach Next-best-action	Cynthia Jenkins: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-027951	Proposed	—
ACT-019397	Care coordination outreach Next-best-action	Kyle Simpson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-027999	Proposed	—
ACT-019398	Care coordination outreach Next-best-action	Heather Pierce: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-028120	Proposed	—
ACT-019399	Care coordination outreach Next-best-action	Betty Pena: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028124	Proposed	—
ACT-019400	Care coordination outreach Next-best-action	Sharon Gilbert: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028162	Proposed	—
ACT-019401	Care coordination outreach Next-best-action	Austin Li: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028187	Proposed	—
ACT-019402	Care coordination outreach Next-best-action	Daniel Lawrence: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028194	Proposed	—
ACT-019403	Care coordination outreach Next-best-action	Isabella Santos: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028204	Proposed	—
ACT-019404	Care coordination outreach Next-best-action	Kathryn Schmidt: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028210	Proposed	—
ACT-019405	Care coordination outreach Next-best-action	Bruce Garrett: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028226	Proposed	—
ACT-019406	Care coordination outreach Next-best-action	Mateo Simpson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028235	Proposed	—
ACT-019407	Care coordination outreach Next-best-action	Gary Valdez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028237	Proposed	—
ACT-019408	Care coordination outreach Next-best-action	Elizabeth Brown: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-028261	Proposed	—
ACT-019409	Care coordination outreach Next-best-action	Mary Fields: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028403	Proposed	—
ACT-019410	Care coordination outreach Next-best-action	Sean Chapman: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028421	Proposed	—
ACT-019411	Care coordination outreach Next-best-action	Dylan Parker: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028448	Proposed	—
ACT-019412	Care coordination outreach Next-best-action	Jean Ward: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028505	Proposed	—
ACT-019413	Care coordination outreach Next-best-action	Jennifer Bradley: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028579	Proposed	—
ACT-019414	Care coordination outreach Next-best-action	Joseph Olson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028584	Proposed	—
ACT-019415	Care coordination outreach Next-best-action	Kevin King: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028615	Proposed	—
ACT-019416	Care coordination outreach Next-best-action	Elizabeth Carr: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028616	Proposed	—
ACT-019417	Care coordination outreach Next-best-action	Danielle Lee: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028626	Proposed	—
ACT-019418	Care coordination outreach Next-best-action	Angela Bailey: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028689	Proposed	—
ACT-019419	Care coordination outreach Next-best-action	Thomas Morales: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028726	Proposed	—
ACT-019420	Care coordination outreach Next-best-action	Christine Phillips: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028757	Proposed	—

3,896 rows, page 33 of 78Previous Next

Derivation rules

Evaluated after every gold rebuild

1
Eligibility conflict resolved
The records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
2
Orphan claim re-pointed
A 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.
3
Outreach address corrected
The most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
4
Outreach suppressed pending steward
The record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
5
Care coordination outreach
Three or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
6
New member onboarding
A single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
7
Duplicate member record retired
Two or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.