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-019739 | New member onboarding Next-best-action | Charlie Warren: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-019740 | New member onboarding Next-best-action | Amanda Riley: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019741 | New member onboarding Next-best-action | Dorothy Hanson: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-019742 | New member onboarding Next-best-action | Fatima Payne: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019743 | New member onboarding Next-best-action | Kevin Hill: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019744 | New member onboarding Next-best-action | Carl Peterson: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019745 | New member onboarding Next-best-action | Frank Wilson: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-019746 | New member onboarding Next-best-action | Nicholas Mendez: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-019747 | New member onboarding Next-best-action | Nicholas Martin: enrolled 2026-10-01, no activity yet |
| Proposed | — | ||
| ACT-019748 | New member onboarding Next-best-action | Carl Elliott: enrolled 2026-10-13, no activity yet |
| Proposed | — | ||
| ACT-019749 | New member onboarding Next-best-action | Dorothy Mason: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-019750 | New member onboarding Next-best-action | Bryan Estrada: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019751 | New member onboarding Next-best-action | Steven Banks: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019752 | New member onboarding Next-best-action | Harold Watkins: enrolled 2026-09-08, no activity yet |
| Proposed | — | ||
| ACT-019753 | New member onboarding Next-best-action | Diane Clark: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019754 | New member onboarding Next-best-action | Ruth Grant: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-019755 | New member onboarding Next-best-action | Ruth Chapman: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-019756 | New member onboarding Next-best-action | Lisa Stewart: enrolled 2026-10-17, no activity yet |
| Proposed | — | ||
| ACT-019757 | New member onboarding Next-best-action | Mary Marquez: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019758 | New member onboarding Next-best-action | David Sullivan: enrolled 2026-10-07, no activity yet |
| Proposed | — | ||
| ACT-019759 | New member onboarding Next-best-action | Randy Sandoval: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019760 | New member onboarding Next-best-action | Gabriel Snyder: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019761 | New member onboarding Next-best-action | John Bryant: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-019762 | New member onboarding Next-best-action | Diane James: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019763 | New member onboarding Next-best-action | Amy Palmer: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-019764 | New member onboarding Next-best-action | Madison Martinez: enrolled 2026-09-08, no activity yet |
| Proposed | — | ||
| ACT-019765 | New member onboarding Next-best-action | Beverly Robinson: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-019766 | New member onboarding Next-best-action | Camila Murphy: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-019767 | New member onboarding Next-best-action | Gloria Bryant: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-019768 | New member onboarding Next-best-action | Julia Long: enrolled 2026-10-05, no activity yet |
| Proposed | — | ||
| ACT-019769 | New member onboarding Next-best-action | Jeremy Stevens: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-019770 | New member onboarding Next-best-action | Kayla Wheeler: enrolled 2026-09-20, no activity yet |
| Proposed | — | ||
| ACT-019771 | New member onboarding Next-best-action | Michael White: enrolled 2026-09-12, no activity yet |
| Proposed | — | ||
| ACT-019772 | New member onboarding Next-best-action | Marilyn Aguilar: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-019773 | New member onboarding Next-best-action | Juan Owens: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-019774 | New member onboarding Next-best-action | Cheryl Oliver: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019775 | New member onboarding Next-best-action | Peter Sims: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-019776 | New member onboarding Next-best-action | David Murray: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-019777 | New member onboarding Next-best-action | Natlaie Dunn: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019778 | New member onboarding Next-best-action | Christine Richardson: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-019779 | New member onboarding Next-best-action | Sharon Williamson: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-019780 | New member onboarding Next-best-action | Jeremy Carpenter: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019781 | New member onboarding Next-best-action | Amber Moreno: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019782 | New member onboarding Next-best-action | Angela Chapmn: enrolled 2026-10-06, no activity yet |
| Proposed | — | ||
| ACT-019783 | New member onboarding Next-best-action | Helen Ross: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-019784 | New member onboarding Next-best-action | Willie Holmes: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-019785 | New member onboarding Next-best-action | Ruth Wheeler: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019786 | New member onboarding Next-best-action | Megan Cook: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019787 | New member onboarding Next-best-action | Arjnu Palmer: enrolled 2026-09-26, no activity yet |
| Proposed | — | ||
| ACT-019788 | New member onboarding Next-best-action | Patricia Bowman: enrolled 2026-10-05, 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.