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-000451 | Eligibility conflict resolved Eligibility engine | Scott Schultz: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000452 | Eligibility conflict resolved Eligibility engine | Raymond Kim: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000453 | Eligibility conflict resolved Eligibility engine | Jacob Riley: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000454 | Eligibility conflict resolved Eligibility engine | Jessica Guerrero: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000455 | Eligibility conflict resolved Eligibility engine | Juan Myers: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000456 | Eligibility conflict resolved Eligibility engine | Theresa Cooper: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000457 | Eligibility conflict resolved Eligibility engine | Logan Ortiz: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000458 | Eligibility conflict resolved Eligibility engine | Joshua Hayes: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000459 | Eligibility conflict resolved Eligibility engine | Joe Kennedy: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000460 | Eligibility conflict resolved Eligibility engine | Zachary Rios: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000461 | Eligibility conflict resolved Eligibility engine | Bryan King: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000462 | Eligibility conflict resolved Eligibility engine | Alexis Mitchell: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000463 | Eligibility conflict resolved Eligibility engine | Christopher Mendoza: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000464 | Eligibility conflict resolved Eligibility engine | Joseph Webb: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000465 | Eligibility conflict resolved Eligibility engine | Keith Schultz: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000466 | Eligibility conflict resolved Eligibility engine | Mariana Webb: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000467 | Eligibility conflict resolved Eligibility engine | Samuel Russell: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000468 | Eligibility conflict resolved Eligibility engine | Teresa Murphy: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000469 | Eligibility conflict resolved Eligibility engine | Victoria Schmidt: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000470 | Eligibility conflict resolved Eligibility engine | Lucia Wood: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000471 | Eligibility conflict resolved Eligibility engine | Mason Ortiz: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000472 | Eligibility conflict resolved Eligibility engine | Susan Guzman: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000473 | Eligibility conflict resolved Eligibility engine | Walter Willis: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000474 | Eligibility conflict resolved Eligibility engine | Emma Coleman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000475 | Eligibility conflict resolved Eligibility engine | Michael Castillo: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000476 | Eligibility conflict resolved Eligibility engine | Russell Dean: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000477 | Eligibility conflict resolved Eligibility engine | Judith Harris: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000478 | Eligibility conflict resolved Eligibility engine | Rachel Walker: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000479 | Eligibility conflict resolved Eligibility engine | Anna Shaw: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000480 | Eligibility conflict resolved Eligibility engine | Jonathan Garrett: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000481 | Eligibility conflict resolved Eligibility engine | Jacqueline Daniels: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000482 | Eligibility conflict resolved Eligibility engine | Melissa Vasquez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000483 | Eligibility conflict resolved Eligibility engine | George Dominguez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000484 | Eligibility conflict resolved Eligibility engine | Andrew Munoz: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000485 | Eligibility conflict resolved Eligibility engine | Kayla Wong: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000486 | Eligibility conflict resolved Eligibility engine | Frank Fernandez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000487 | Eligibility conflict resolved Eligibility engine | Frank Garrett: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000488 | Eligibility conflict resolved Eligibility engine | Alice Walsh: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000489 | Eligibility conflict resolved Eligibility engine | Walter Ward: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000490 | Eligibility conflict resolved Eligibility engine | Luis Hill: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000491 | Eligibility conflict resolved Eligibility engine | Andrea Espinoza: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000492 | Eligibility conflict resolved Eligibility engine | Doris Fernandez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000493 | Eligibility conflict resolved Eligibility engine | Alex Husdon: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000494 | Eligibility conflict resolved Eligibility engine | Tyler Maldonado: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000495 | Eligibility conflict resolved Eligibility engine | Gloria Perez: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000496 | Eligibility conflict resolved Eligibility engine | Raymond Elliott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000497 | Eligibility conflict resolved Eligibility engine | Frank Lawrence: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000498 | Eligibility conflict resolved Eligibility engine | Brenda Tran: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000499 | Eligibility conflict resolved Eligibility engine | Frank Robertson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000500 | Eligibility conflict resolved Eligibility engine | Deborah Hicks: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| 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.