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
New member onboarding, Next-best-action, 2,081 proposed
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| 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 | — | ||
| ACT-019621 | New member onboarding Next-best-action | Jacob Knight: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019622 | New member onboarding Next-best-action | Jerry Clark: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-019623 | New member onboarding Next-best-action | Kathleen Harriosn: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-019624 | New member onboarding Next-best-action | Cheryl Patel: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-019625 | New member onboarding Next-best-action | Jacqueline Schultz: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019626 | New member onboarding Next-best-action | Anthony Gutierrez: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019627 | New member onboarding Next-best-action | Paul Garrett: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019628 | New member onboarding Next-best-action | Andrea Reid: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019629 | New member onboarding Next-best-action | Randy Thompon: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019630 | New member onboarding Next-best-action | Grace Webb: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019631 | New member onboarding Next-best-action | Ralph Rice: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-019632 | New member onboarding Next-best-action | Alexander Nichols: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019633 | New member onboarding Next-best-action | Roy Willis: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019634 | New member onboarding Next-best-action | Brenda Shaw: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019635 | New member onboarding Next-best-action | Zachary Franklin: enrolled 2026-10-06, 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.