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-000751 | Eligibility conflict resolved Eligibility engine | Valentina Ramos: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000752 | Eligibility conflict resolved Eligibility engine | Angela Woods: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000753 | Eligibility conflict resolved Eligibility engine | Jeremy Fernandez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000754 | Eligibility conflict resolved Eligibility engine | George Brown: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000755 | Eligibility conflict resolved Eligibility engine | Kimberly Burns: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000756 | Eligibility conflict resolved Eligibility engine | Alice Graham: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000757 | Eligibility conflict resolved Eligibility engine | Logan Payne: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000758 | Eligibility conflict resolved Eligibility engine | Megan Brown: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000759 | Eligibility conflict resolved Eligibility engine | Betty Henderson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000760 | Eligibility conflict resolved Eligibility engine | Mark Perez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000761 | Eligibility conflict resolved Eligibility engine | Carlos Scott: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000762 | Eligibility conflict resolved Eligibility engine | Ralph Burns: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000763 | Eligibility conflict resolved Eligibility engine | Debra Mills: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000764 | Eligibility conflict resolved Eligibility engine | Lori Gibson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000765 | Eligibility conflict resolved Eligibility engine | Elizabeth Ray: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000766 | Eligibility conflict resolved Eligibility engine | Jeffrey Griffin: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000767 | Eligibility conflict resolved Eligibility engine | Russell Powell: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000768 | Eligibility conflict resolved Eligibility engine | Anthony Taylor: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000769 | Eligibility conflict resolved Eligibility engine | Mark Johnson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000770 | Eligibility conflict resolved Eligibility engine | Gabriel Reynolds: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000771 | Eligibility conflict resolved Eligibility engine | Sara Gordon: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000772 | Eligibility conflict resolved Eligibility engine | Ann Harris: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000773 | Eligibility conflict resolved Eligibility engine | David Yang: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000774 | Eligibility conflict resolved Eligibility engine | Mason Munoz: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000775 | Eligibility conflict resolved Eligibility engine | James Crawford: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000776 | Eligibility conflict resolved Eligibility engine | Kim Lee: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000777 | Eligibility conflict resolved Eligibility engine | Ruth Jordan: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000778 | Eligibility conflict resolved Eligibility engine | Bryan Burke: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000779 | Eligibility conflict resolved Eligibility engine | Victoria Hawkins: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000780 | Eligibility conflict resolved Eligibility engine | Mason Marquez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000781 | Eligibility conflict resolved Eligibility engine | Cynthia Kelley: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000782 | Eligibility conflict resolved Eligibility engine | Beverly Schultz: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000783 | Eligibility conflict resolved Eligibility engine | Sandra Barnes: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000784 | Eligibility conflict resolved Eligibility engine | Katherine Walker: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000785 | Eligibility conflict resolved Eligibility engine | Dennis Moore: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000786 | Eligibility conflict resolved Eligibility engine | Sarah Bailey: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000787 | Eligibility conflict resolved Eligibility engine | Eugene Henderson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000788 | Eligibility conflict resolved Eligibility engine | David Coleman: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000789 | Eligibility conflict resolved Eligibility engine | Megan Gomez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000790 | Eligibility conflict resolved Eligibility engine | Cheryl Vazquez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000791 | Eligibility conflict resolved Eligibility engine | Daniel Marshall: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000792 | Eligibility conflict resolved Eligibility engine | Rebecca Hart: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000793 | Eligibility conflict resolved Eligibility engine | Austin Palmer: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000794 | Eligibility conflict resolved Eligibility engine | Martha Warren: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000795 | Eligibility conflict resolved Eligibility engine | Joseph Day: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000796 | Eligibility conflict resolved Eligibility engine | Cynthia Lucas: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000797 | Eligibility conflict resolved Eligibility engine | Andrew Little: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000798 | Eligibility conflict resolved Eligibility engine | Joe Salazar: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000799 | Eligibility conflict resolved Eligibility engine | Jacqueline Garza: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000800 | Eligibility conflict resolved Eligibility engine | Cheryl Padilla: 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.