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-020171 | New member onboarding Next-best-action | Patricia Greeen: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-020172 | New member onboarding Next-best-action | Bradley Murphy: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-020173 | New member onboarding Next-best-action | Kelly Gordon: enrolled 2026-09-11, no activity yet |
| Proposed | — | ||
| ACT-020174 | New member onboarding Next-best-action | Zachary Young: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-020175 | New member onboarding Next-best-action | Debra Baileey: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-020176 | New member onboarding Next-best-action | Christine Hughes: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020177 | New member onboarding Next-best-action | Charlotte Ausstin: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-020178 | New member onboarding Next-best-action | Roger Castillo: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-020179 | New member onboarding Next-best-action | Wayne Martinez: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-020180 | New member onboarding Next-best-action | Nathan Pena: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-020181 | New member onboarding Next-best-action | Abigali Shaw: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-020182 | New member onboarding Next-best-action | Gloria Larson: enrolled 2026-09-29, no activity yet |
| Proposed | — | ||
| ACT-020183 | New member onboarding Next-best-action | Terry Gonzales: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-020184 | New member onboarding Next-best-action | Priya Hughes: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020185 | New member onboarding Next-best-action | Megan Johnston: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-020186 | New member onboarding Next-best-action | Tony Moreno: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020187 | New member onboarding Next-best-action | Timothy Fields: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-020188 | New member onboarding Next-best-action | Isabella Adams: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-020189 | New member onboarding Next-best-action | Helen Graham: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020190 | New member onboarding Next-best-action | Alice Henry: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-020191 | New member onboarding Next-best-action | Randy Roberts: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-020192 | New member onboarding Next-best-action | Luis Jimenez: enrolled 2026-09-11, no activity yet |
| Proposed | — | ||
| ACT-020193 | New member onboarding Next-best-action | Diana Barnes: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-020194 | New member onboarding Next-best-action | Elizabeth Ford: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-020195 | New member onboarding Next-best-action | Kevin Franklin: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-020196 | New member onboarding Next-best-action | Santiago Yang: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-020197 | New member onboarding Next-best-action | Gregory Meyer: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-020198 | New member onboarding Next-best-action | Albert Meyer: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-020199 | New member onboarding Next-best-action | Ethan Johnson: enrolled 2026-10-13, no activity yet |
| Proposed | — | ||
| ACT-020200 | New member onboarding Next-best-action | Alexis Pena: enrolled 2026-09-11, no activity yet |
| Proposed | — | ||
| ACT-020201 | New member onboarding Next-best-action | Mrk Silvva: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-020202 | New member onboarding Next-best-action | Sandra Franklin: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-020203 | New member onboarding Next-best-action | Angela Walsh: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-020204 | New member onboarding Next-best-action | Randy Myers: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-020205 | New member onboarding Next-best-action | Paul Castillo: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-020206 | New member onboarding Next-best-action | Lauren Anderson: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-020207 | New member onboarding Next-best-action | Andrea Thomas: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-020208 | New member onboarding Next-best-action | Carol Gordon: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020209 | New member onboarding Next-best-action | Janice Ellis: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-020210 | New member onboarding Next-best-action | Roegr Ferguson: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-020211 | New member onboarding Next-best-action | Randy Washington: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-020212 | New member onboarding Next-best-action | Nancy Castor: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-020213 | New member onboarding Next-best-action | Bradley Mason: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-020214 | New member onboarding Next-best-action | Bobby Bowman: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-020215 | New member onboarding Next-best-action | Stephanie Lawrence: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-020216 | New member onboarding Next-best-action | Juan Gonzalez: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-020217 | New member onboarding Next-best-action | Bobby Martin: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-020218 | New member onboarding Next-best-action | Jacob Hamilton: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-020219 | New member onboarding Next-best-action | Terry Bell: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-020220 | New member onboarding Next-best-action | Bradley Rice: enrolled 2026-09-08, 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.