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-019571 | Care coordination outreach Next-best-action | Shaaron Burns: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019572 | Care coordination outreach Next-best-action | Sareh Carter: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019573 | Care coordination outreach Next-best-action | Daniel Rios: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019574 | Care coordination outreach Next-best-action | Abigail Phillips: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019575 | Care coordination outreach Next-best-action | Lauren Lynch: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-019576 | Care coordination outreach Next-best-action | Beverly Hughes: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019577 | Care coordination outreach Next-best-action | Nancy Tran: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019578 | Care coordination outreach Next-best-action | Karen Wells: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019579 | Care coordination outreach Next-best-action | Alice Hart: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019580 | Care coordination outreach Next-best-action | Gary Espinoza: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019581 | Care coordination outreach Next-best-action | Susan Scott: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019582 | Care coordination outreach Next-best-action | Jacqueline Willis: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019583 | Care coordination outreach Next-best-action | Kenneth Morgan: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019584 | Care coordination outreach Next-best-action | Christina Burke: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019585 | Care coordination outreach Next-best-action | Rebecca Sandoval: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019586 | New member onboarding Next-best-action | Helen Jenkins: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019587 | New member onboarding Next-best-action | Mateo Guzman: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-019588 | New member onboarding Next-best-action | Albert Montgomery: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-019589 | New member onboarding Next-best-action | Paul Jones: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019590 | New member onboarding Next-best-action | Ben Stone: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019591 | New member onboarding Next-best-action | Kayla Chavez: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019592 | New member onboarding Next-best-action | Sofia Ellis: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019593 | New member onboarding Next-best-action | Kevin Parker: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019594 | New member onboarding Next-best-action | Powell Lisa: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019595 | New member onboarding Next-best-action | Ethan Morgan: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019596 | New member onboarding Next-best-action | Terry Padilla: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-019597 | New member onboarding Next-best-action | Katherine Sanders: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-019598 | New member onboarding Next-best-action | Edward Vazquez: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-019599 | New member onboarding Next-best-action | Heather White: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-019600 | New member onboarding Next-best-action | Alexxander Parker: enrolled 2026-09-08, no activity yet |
| Proposed | — | ||
| ACT-019601 | New member onboarding Next-best-action | Rios Ralph: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019602 | New member onboarding Next-best-action | Thomas Anderson: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019603 | New member onboarding Next-best-action | Gery Nelson: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019604 | New member onboarding Next-best-action | Patrick Nelson: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019605 | New member onboarding Next-best-action | Jsaon Cruz: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019606 | New member onboarding Next-best-action | Diane Burtton: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019607 | New member onboarding Next-best-action | Andrew Jones: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-019608 | New member onboarding Next-best-action | William Henry: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019609 | New member onboarding Next-best-action | Diego Nunez: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019610 | New member onboarding Next-best-action | Lawrence Wheeler: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-019611 | New member onboarding Next-best-action | Amy Holmes: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019612 | New member onboarding Next-best-action | Alice Burke: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019613 | New member onboarding Next-best-action | Mei Garza: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019614 | New member onboarding Next-best-action | Cynthia Fisher: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-019615 | New member onboarding Next-best-action | Contreras Priya: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019616 | New member onboarding Next-best-action | Jordan Isabella: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-019617 | New member onboarding Next-best-action | Debra Patterson: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-019618 | New member onboarding Next-best-action | Zachary Sullivaan: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-019619 | New member onboarding Next-best-action | Kimberly Fox: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019620 | New member onboarding Next-best-action | Beth Ramirez: enrolled 2026-09-22, no activity yet |
| 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.