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-000551 | Eligibility conflict resolved Eligibility engine | Mari Mejia: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000552 | Eligibility conflict resolved Eligibility engine | Carl Sims: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000553 | Eligibility conflict resolved Eligibility engine | Jordan Wheeler: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000554 | Eligibility conflict resolved Eligibility engine | Brandon Martin: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000555 | Eligibility conflict resolved Eligibility engine | Valentina Johnson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000556 | Eligibility conflict resolved Eligibility engine | Steven Phillips: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000557 | Eligibility conflict resolved Eligibility engine | Cheryl Wang: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000558 | Eligibility conflict resolved Eligibility engine | Debra Jensen: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000559 | Eligibility conflict resolved Eligibility engine | Timothy Wong: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000560 | Eligibility conflict resolved Eligibility engine | Arthur Guzman: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000561 | Eligibility conflict resolved Eligibility engine | Katherine Rivera: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000562 | Eligibility conflict resolved Eligibility engine | Rebecca Roberts: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000563 | Eligibility conflict resolved Eligibility engine | Eugene Mills: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000564 | Eligibility conflict resolved Eligibility engine | Katherine Marshall: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000565 | Eligibility conflict resolved Eligibility engine | Ahmed Ford: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000566 | Eligibility conflict resolved Eligibility engine | Walter Soto: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000567 | Eligibility conflict resolved Eligibility engine | Luis Hunt: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000568 | Eligibility conflict resolved Eligibility engine | Patrick Nichols: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000569 | Eligibility conflict resolved Eligibility engine | Ryan Rojas: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000570 | Eligibility conflict resolved Eligibility engine | Roy Mejia: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000571 | Eligibility conflict resolved Eligibility engine | Stephanie Thomas: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000572 | Eligibility conflict resolved Eligibility engine | Douglas Hughes: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000573 | Eligibility conflict resolved Eligibility engine | Jacob Evans: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000574 | Eligibility conflict resolved Eligibility engine | Teresa Hayes: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000575 | Eligibility conflict resolved Eligibility engine | Jennifer Singh: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000576 | Eligibility conflict resolved Eligibility engine | Mason Baker: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000577 | Eligibility conflict resolved Eligibility engine | Rebecca Fox: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000578 | Eligibility conflict resolved Eligibility engine | Austin Harvey: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000579 | Eligibility conflict resolved Eligibility engine | Brandon Mason: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000580 | Eligibility conflict resolved Eligibility engine | Ann McCoy: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000581 | Eligibility conflict resolved Eligibility engine | Virginia Black: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000582 | Eligibility conflict resolved Eligibility engine | Teresa Fox: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000583 | Eligibility conflict resolved Eligibility engine | Ashley Marshall: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000584 | Eligibility conflict resolved Eligibility engine | Susan Clark: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000585 | Eligibility conflict resolved Eligibility engine | Joyce Watkins: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000586 | Eligibility conflict resolved Eligibility engine | Maria Hanson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000587 | Eligibility conflict resolved Eligibility engine | Kimberly Green: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000588 | Eligibility conflict resolved Eligibility engine | Benjamin Brown: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000589 | Eligibility conflict resolved Eligibility engine | Tyler Jackson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000590 | Eligibility conflict resolved Eligibility engine | Brandon Mason: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000591 | Eligibility conflict resolved Eligibility engine | Terry Hansen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000592 | Eligibility conflict resolved Eligibility engine | Hiroshi Rogers: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000593 | Eligibility conflict resolved Eligibility engine | Madison Moreno: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000594 | Eligibility conflict resolved Eligibility engine | Stephen Harrison: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000595 | Eligibility conflict resolved Eligibility engine | Sanders Samantha: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000596 | Eligibility conflict resolved Eligibility engine | Beverly Andrews: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000597 | Eligibility conflict resolved Eligibility engine | Sofia Warren: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000598 | Eligibility conflict resolved Eligibility engine | Anna Meyer: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000599 | Eligibility conflict resolved Eligibility engine | Mariana Herrera: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000600 | Eligibility conflict resolved Eligibility engine | Brandon Fox: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| 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.