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-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.