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-000651 | Eligibility conflict resolved Eligibility engine | Jordan Stone: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000652 | Eligibility conflict resolved Eligibility engine | Betty Hart: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000653 | Eligibility conflict resolved Eligibility engine | Heather Lynch: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000654 | Eligibility conflict resolved Eligibility engine | Lawrence Flores: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000655 | Eligibility conflict resolved Eligibility engine | Stephanie Hamilton: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000656 | Eligibility conflict resolved Eligibility engine | Billy Ramirez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000657 | Eligibility conflict resolved Eligibility engine | Mason Sanchez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000658 | Eligibility conflict resolved Eligibility engine | Yuki Porter: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000659 | Eligibility conflict resolved Eligibility engine | Vincent Le: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000660 | Eligibility conflict resolved Eligibility engine | Michael Hanson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000661 | Eligibility conflict resolved Eligibility engine | Patricia Kennedy: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000662 | Eligibility conflict resolved Eligibility engine | Danielle Henry: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000663 | Eligibility conflict resolved Eligibility engine | Debra Bryant: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000664 | Eligibility conflict resolved Eligibility engine | Beverly Carlson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000665 | Eligibility conflict resolved Eligibility engine | Virginia Guerrero: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000666 | Eligibility conflict resolved Eligibility engine | Carl Campbell: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000667 | Eligibility conflict resolved Eligibility engine | Lori Wright: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000668 | Eligibility conflict resolved Eligibility engine | Roger Carroll: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000669 | Eligibility conflict resolved Eligibility engine | Isabella Rose: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000670 | Eligibility conflict resolved Eligibility engine | Melissa Hudson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000671 | Eligibility conflict resolved Eligibility engine | Brittany Hill: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000672 | Eligibility conflict resolved Eligibility engine | Camila Price: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000673 | Eligibility conflict resolved Eligibility engine | Joyce Vega: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000674 | Eligibility conflict resolved Eligibility engine | Laura Ellis: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000675 | Eligibility conflict resolved Eligibility engine | Hiroshi Schultz: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000676 | Eligibility conflict resolved Eligibility engine | Alice Perkins: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000677 | Eligibility conflict resolved Eligibility engine | Arthur Hunt: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000678 | Eligibility conflict resolved Eligibility engine | Priya Pena: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000679 | Eligibility conflict resolved Eligibility engine | Judy Knight: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000680 | Eligibility conflict resolved Eligibility engine | Rachel Fowler: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000681 | Eligibility conflict resolved Eligibility engine | Sharon Stone: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000682 | Eligibility conflict resolved Eligibility engine | Fatima Vasquez: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000683 | Eligibility conflict resolved Eligibility engine | Ahmed Fisher: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000684 | Eligibility conflict resolved Eligibility engine | Bryan Mills: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000685 | Eligibility conflict resolved Eligibility engine | Bradley Jones: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000686 | Eligibility conflict resolved Eligibility engine | Alan Gilbert: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000687 | Eligibility conflict resolved Eligibility engine | Dorothy Bennett: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000688 | Eligibility conflict resolved Eligibility engine | Arthur Cooper: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000689 | Eligibility conflict resolved Eligibility engine | Russell Spencer: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000690 | Eligibility conflict resolved Eligibility engine | Jesse Contreras: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000691 | Eligibility conflict resolved Eligibility engine | Mason Brown: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000692 | Eligibility conflict resolved Eligibility engine | Joyce Wells: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000693 | Eligibility conflict resolved Eligibility engine | Donna Jenkins: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000694 | Eligibility conflict resolved Eligibility engine | Lawrence Chapman: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000695 | Eligibility conflict resolved Eligibility engine | Nicholas Cunningham: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000696 | Eligibility conflict resolved Eligibility engine | Billy Hansen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000697 | Eligibility conflict resolved Eligibility engine | Marc Stephens: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000698 | Eligibility conflict resolved Eligibility engine | Kayla Harris: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000699 | Eligibility conflict resolved Eligibility engine | Tyler Yang: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000700 | Eligibility conflict resolved Eligibility engine | Alexander Wells: 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.