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-019589 | New member onboarding Next-best-action | Paul Jones: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019590 | New member onboarding Next-best-action | Ben Stone: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019591 | New member onboarding Next-best-action | Kayla Chavez: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019592 | New member onboarding Next-best-action | Sofia Ellis: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019593 | New member onboarding Next-best-action | Kevin Parker: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019594 | New member onboarding Next-best-action | Powell Lisa: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019595 | New member onboarding Next-best-action | Ethan Morgan: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019596 | New member onboarding Next-best-action | Terry Padilla: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-019597 | New member onboarding Next-best-action | Katherine Sanders: enrolled 2026-09-10, no activity yet |
| Proposed | — | ||
| ACT-019598 | New member onboarding Next-best-action | Edward Vazquez: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-019599 | New member onboarding Next-best-action | Heather White: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-019600 | New member onboarding Next-best-action | Alexxander Parker: enrolled 2026-09-08, no activity yet |
| Proposed | — | ||
| ACT-019601 | New member onboarding Next-best-action | Rios Ralph: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019602 | New member onboarding Next-best-action | Thomas Anderson: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019603 | New member onboarding Next-best-action | Gery Nelson: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019604 | New member onboarding Next-best-action | Patrick Nelson: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019605 | New member onboarding Next-best-action | Jsaon Cruz: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019606 | New member onboarding Next-best-action | Diane Burtton: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019607 | New member onboarding Next-best-action | Andrew Jones: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-019608 | New member onboarding Next-best-action | William Henry: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019609 | New member onboarding Next-best-action | Diego Nunez: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019610 | New member onboarding Next-best-action | Lawrence Wheeler: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-019611 | New member onboarding Next-best-action | Amy Holmes: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019612 | New member onboarding Next-best-action | Alice Burke: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019613 | New member onboarding Next-best-action | Mei Garza: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019614 | New member onboarding Next-best-action | Cynthia Fisher: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-019615 | New member onboarding Next-best-action | Contreras Priya: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019616 | New member onboarding Next-best-action | Jordan Isabella: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-019617 | New member onboarding Next-best-action | Debra Patterson: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-019618 | New member onboarding Next-best-action | Zachary Sullivaan: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-019619 | New member onboarding Next-best-action | Kimberly Fox: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019620 | New member onboarding Next-best-action | Beth Ramirez: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-019621 | New member onboarding Next-best-action | Jacob Knight: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019622 | New member onboarding Next-best-action | Jerry Clark: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-019623 | New member onboarding Next-best-action | Kathleen Harriosn: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-019624 | New member onboarding Next-best-action | Cheryl Patel: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-019625 | New member onboarding Next-best-action | Jacqueline Schultz: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019626 | New member onboarding Next-best-action | Anthony Gutierrez: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019627 | New member onboarding Next-best-action | Paul Garrett: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019628 | New member onboarding Next-best-action | Andrea Reid: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019629 | New member onboarding Next-best-action | Randy Thompon: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019630 | New member onboarding Next-best-action | Grace Webb: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019631 | New member onboarding Next-best-action | Ralph Rice: enrolled 2026-10-16, no activity yet |
| Proposed | — | ||
| ACT-019632 | New member onboarding Next-best-action | Alexander Nichols: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019633 | New member onboarding Next-best-action | Roy Willis: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019634 | New member onboarding Next-best-action | Brenda Shaw: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019635 | New member onboarding Next-best-action | Zachary Franklin: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-019636 | New member onboarding Next-best-action | Aaron Snigh: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019637 | New member onboarding Next-best-action | Hamilton Doris: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019638 | New member onboarding Next-best-action | Sofiia Pena: enrolled 2026-09-25, 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.