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-000701 | Eligibility conflict resolved Eligibility engine | Brittany Hawkins: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000702 | Eligibility conflict resolved Eligibility engine | Raymond Armstrong: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000703 | Eligibility conflict resolved Eligibility engine | Mariana Meyer: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000704 | Eligibility conflict resolved Eligibility engine | Nancy Castillo: 3 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000705 | Eligibility conflict resolved Eligibility engine | Karen Welch: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000706 | Eligibility conflict resolved Eligibility engine | Andrea Bryant: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000707 | Eligibility conflict resolved Eligibility engine | Marcus Richards: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000708 | Eligibility conflict resolved Eligibility engine | Jeffrey Cook: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000709 | Eligibility conflict resolved Eligibility engine | Ruth Meyer: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000710 | Eligibility conflict resolved Eligibility engine | Carolyn Wallace: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000711 | Eligibility conflict resolved Eligibility engine | Diego Ramos: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000712 | Eligibility conflict resolved Eligibility engine | Jacob Pierce: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000713 | Eligibility conflict resolved Eligibility engine | Donald Payne: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000714 | Eligibility conflict resolved Eligibility engine | Kayla Knight: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000715 | Eligibility conflict resolved Eligibility engine | Ahmed Wells: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000716 | Eligibility conflict resolved Eligibility engine | Michelle Jensen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000717 | Eligibility conflict resolved Eligibility engine | Roger Reid: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000718 | Eligibility conflict resolved Eligibility engine | Jose Roberts: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000719 | Eligibility conflict resolved Eligibility engine | Keith Brooks: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000720 | Eligibility conflict resolved Eligibility engine | Kimberly Lawson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000721 | Eligibility conflict resolved Eligibility engine | Nancy Andrews: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000722 | Eligibility conflict resolved Eligibility engine | Jeremy Nguyen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000723 | Eligibility conflict resolved Eligibility engine | Margaret Gutierrez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000724 | Eligibility conflict resolved Eligibility engine | Melissa Gardner: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000725 | Eligibility conflict resolved Eligibility engine | Sharon Day: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000726 | Eligibility conflict resolved Eligibility engine | Charles Taylor: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000727 | Eligibility conflict resolved Eligibility engine | Alexis Hunt: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000728 | Eligibility conflict resolved Eligibility engine | Bruce Wilson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000729 | Eligibility conflict resolved Eligibility engine | Kimberly Ryan: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000730 | Eligibility conflict resolved Eligibility engine | Christopher Guerrero: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000731 | Eligibility conflict resolved Eligibility engine | Sarah Ward: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000732 | Eligibility conflict resolved Eligibility engine | Aaron Bailey: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000733 | Eligibility conflict resolved Eligibility engine | Elijah Fields: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000734 | Eligibility conflict resolved Eligibility engine | Albert Espinoza: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000735 | Eligibility conflict resolved Eligibility engine | Melissa Cruz: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000736 | Eligibility conflict resolved Eligibility engine | Jerry Dean: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000737 | Eligibility conflict resolved Eligibility engine | Juan Richards: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000738 | Eligibility conflict resolved Eligibility engine | Harold Tran: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000739 | Eligibility conflict resolved Eligibility engine | Ashley Cox: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000740 | Eligibility conflict resolved Eligibility engine | Lisa Soto: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000741 | Eligibility conflict resolved Eligibility engine | Angela Garrett: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000742 | Eligibility conflict resolved Eligibility engine | Beverly Hunter: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000743 | Eligibility conflict resolved Eligibility engine | Nancy Wheeler: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000744 | Eligibility conflict resolved Eligibility engine | Arthur Kelley: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000745 | Eligibility conflict resolved Eligibility engine | Anna Lawrence: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000746 | Eligibility conflict resolved Eligibility engine | Carolyn Wong: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000747 | Eligibility conflict resolved Eligibility engine | Jesse Hernandez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000748 | Eligibility conflict resolved Eligibility engine | Angela Espinoza: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000749 | Eligibility conflict resolved Eligibility engine | Nick Garrett: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000750 | Eligibility conflict resolved Eligibility engine | Alexander Ray: 2 plan codes across sources → canonical CORE-HMO |
| 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.