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-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.