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
Eligibility conflict resolved, Eligibility engine, 1,339 proposed
| 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.