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-000601 | Eligibility conflict resolved Eligibility engine | Grace Lawrence: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000602 | Eligibility conflict resolved Eligibility engine | Arjun Fowler: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000603 | Eligibility conflict resolved Eligibility engine | Bobby Freeman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000604 | Eligibility conflict resolved Eligibility engine | Amy Davis: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000605 | Eligibility conflict resolved Eligibility engine | Richard Wright: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000606 | Eligibility conflict resolved Eligibility engine | Hannah Lane: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000607 | Eligibility conflict resolved Eligibility engine | Amber Howell: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000608 | Eligibility conflict resolved Eligibility engine | Keith Smith: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000609 | Eligibility conflict resolved Eligibility engine | Sarah Saarah: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000610 | Eligibility conflict resolved Eligibility engine | Cruz Paul: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000611 | Eligibility conflict resolved Eligibility engine | Robert Holmes: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000612 | Eligibility conflict resolved Eligibility engine | Terry Gomez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000613 | Eligibility conflict resolved Eligibility engine | Carolyn Chen: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000614 | Eligibility conflict resolved Eligibility engine | Jesse Bryant: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000615 | Eligibility conflict resolved Eligibility engine | James Rice: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000616 | Eligibility conflict resolved Eligibility engine | Melissa Wright: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000617 | Eligibility conflict resolved Eligibility engine | Donald Donald: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000618 | Eligibility conflict resolved Eligibility engine | Nancy George: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000619 | Eligibility conflict resolved Eligibility engine | Christopher Peterson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000620 | Eligibility conflict resolved Eligibility engine | Lawrence Hayes: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000621 | Eligibility conflict resolved Eligibility engine | Jeffrey Payne: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000622 | Eligibility conflict resolved Eligibility engine | Terry Snyder: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000623 | Eligibility conflict resolved Eligibility engine | Elijah Wilson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000624 | Eligibility conflict resolved Eligibility engine | Amanda Morrison: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000625 | Eligibility conflict resolved Eligibility engine | Andrew Ford: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000626 | Eligibility conflict resolved Eligibility engine | Santiago Howell: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000627 | Eligibility conflict resolved Eligibility engine | Gloria Harper: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000628 | Eligibility conflict resolved Eligibility engine | Timothy Webb: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000629 | Eligibility conflict resolved Eligibility engine | Roy Coleman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000630 | Eligibility conflict resolved Eligibility engine | Brrian Gray: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000631 | Eligibility conflict resolved Eligibility engine | Rachel Flores: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000632 | Eligibility conflict resolved Eligibility engine | Daniel Garcia: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000633 | Eligibility conflict resolved Eligibility engine | Sean Stephens: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000634 | Eligibility conflict resolved Eligibility engine | Mary Singh: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000635 | Eligibility conflict resolved Eligibility engine | Michelle Andrews: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000636 | Eligibility conflict resolved Eligibility engine | Ralph Williamson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000637 | Eligibility conflict resolved Eligibility engine | Patrick Schmidt: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000638 | Eligibility conflict resolved Eligibility engine | Heather Le: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000639 | Eligibility conflict resolved Eligibility engine | Brittany Ferguson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000640 | Eligibility conflict resolved Eligibility engine | Jeffrey Mendoza: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000641 | Eligibility conflict resolved Eligibility engine | Alexander Payne: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000642 | Eligibility conflict resolved Eligibility engine | Julie Larson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000643 | Eligibility conflict resolved Eligibility engine | Raymond Wood: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000644 | Eligibility conflict resolved Eligibility engine | Amber Valdez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000645 | Eligibility conflict resolved Eligibility engine | Charlotte Shaw: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000646 | Eligibility conflict resolved Eligibility engine | Lucia Welch: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000647 | Eligibility conflict resolved Eligibility engine | Paul Riley: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000648 | Eligibility conflict resolved Eligibility engine | Aaron Garza: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000649 | Eligibility conflict resolved Eligibility engine | Nicholas Carter: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000650 | Eligibility conflict resolved Eligibility engine | Richard Herrera: 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.