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-019539 | Care coordination outreach Next-best-action | Jose Reyes: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019540 | Care coordination outreach Next-best-action | Nicholas Clark: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019541 | Care coordination outreach Next-best-action | Douglas Harris: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019542 | Care coordination outreach Next-best-action | Mei Hudson: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019543 | Care coordination outreach Next-best-action | Santiago Martinez: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019544 | Care coordination outreach Next-best-action | Gary Thompson: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019545 | Care coordination outreach Next-best-action | Andrew Davis: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019546 | Care coordination outreach Next-best-action | Nicole Hughes: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019547 | Care coordination outreach Next-best-action | Samantha Fowler: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019548 | Care coordination outreach Next-best-action | Steven Carroll: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019549 | Care coordination outreach Next-best-action | Kayla Gardner: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019550 | Care coordination outreach Next-best-action | Sara Hawkins: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019551 | Care coordination outreach Next-best-action | Jessica Elllis: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019552 | Care coordination outreach Next-best-action | Wayne Santiago: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019553 | Care coordination outreach Next-best-action | Thomas Chavez: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019554 | Care coordination outreach Next-best-action | Anthony Ross: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019555 | Care coordination outreach Next-best-action | Kathleen Fisher: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019556 | Care coordination outreach Next-best-action | Ahmed Le: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019557 | Care coordination outreach Next-best-action | Kevin Cunningham: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019558 | Care coordination outreach Next-best-action | Heather Welch: 5 claims, no attributed provider |
| Proposed | — | ||
| ACT-019559 | Care coordination outreach Next-best-action | Elijah Bishop: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019560 | Care coordination outreach Next-best-action | Kevin Mejia: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019561 | Care coordination outreach Next-best-action | Amber Contreras: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019562 | Care coordination outreach Next-best-action | Jeffrey Fernandez: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019563 | Care coordination outreach Next-best-action | Henry Ross: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019564 | Care coordination outreach Next-best-action | Jacqueline Fowler: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019565 | Care coordination outreach Next-best-action | Marcus Munoz: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019566 | Care coordination outreach Next-best-action | Camila Ortiz: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-019567 | Care coordination outreach Next-best-action | Amber Walker: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019568 | Care coordination outreach Next-best-action | Amber Delgado: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019569 | Care coordination outreach Next-best-action | Keith Silva: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019570 | Care coordination outreach Next-best-action | Bruce Watson: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019571 | Care coordination outreach Next-best-action | Shaaron Burns: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019572 | Care coordination outreach Next-best-action | Sareh Carter: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019573 | Care coordination outreach Next-best-action | Daniel Rios: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019574 | Care coordination outreach Next-best-action | Abigail Phillips: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019575 | Care coordination outreach Next-best-action | Lauren Lynch: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-019576 | Care coordination outreach Next-best-action | Beverly Hughes: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019577 | Care coordination outreach Next-best-action | Nancy Tran: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019578 | Care coordination outreach Next-best-action | Karen Wells: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019579 | Care coordination outreach Next-best-action | Alice Hart: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019580 | Care coordination outreach Next-best-action | Gary Espinoza: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019581 | Care coordination outreach Next-best-action | Susan Scott: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019582 | Care coordination outreach Next-best-action | Jacqueline Willis: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019583 | Care coordination outreach Next-best-action | Kenneth Morgan: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019584 | Care coordination outreach Next-best-action | Christina Burke: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-019585 | Care coordination outreach Next-best-action | Rebecca Sandoval: 3 claims, no attributed provider |
| Proposed | — | ||
| 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 | — |
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.