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-000801 | Eligibility conflict resolved Eligibility engine | Danielle Duncan: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000802 | Eligibility conflict resolved Eligibility engine | Michelle Fuller: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000803 | Eligibility conflict resolved Eligibility engine | Jessica Reid: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000804 | Eligibility conflict resolved Eligibility engine | Wayne Lopez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000805 | Eligibility conflict resolved Eligibility engine | Adam Dunn: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000806 | Eligibility conflict resolved Eligibility engine | Aisha Salazar: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000807 | Eligibility conflict resolved Eligibility engine | Tyler Rice: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000808 | Eligibility conflict resolved Eligibility engine | Bradley Stewart: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000809 | Eligibility conflict resolved Eligibility engine | Janet Fernandez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000810 | Eligibility conflict resolved Eligibility engine | Carol Espinoza: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000811 | Eligibility conflict resolved Eligibility engine | Noah Cooper: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000812 | Eligibility conflict resolved Eligibility engine | Judith Daniels: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000813 | Eligibility conflict resolved Eligibility engine | John Burke: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000814 | Eligibility conflict resolved Eligibility engine | Mark Freeman: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000815 | Eligibility conflict resolved Eligibility engine | Mei Johnson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000816 | Eligibility conflict resolved Eligibility engine | Willie Austin: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000817 | Eligibility conflict resolved Eligibility engine | Maria Palmer: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000818 | Eligibility conflict resolved Eligibility engine | Grace Kelly: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000819 | Eligibility conflict resolved Eligibility engine | Bruce Rios: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000820 | Eligibility conflict resolved Eligibility engine | Scott Duncan: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000821 | Eligibility conflict resolved Eligibility engine | Vincent Ruiz: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000822 | Eligibility conflict resolved Eligibility engine | Jose Howell: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000823 | Eligibility conflict resolved Eligibility engine | Philip Olson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000824 | Eligibility conflict resolved Eligibility engine | Gloria Watkins: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000825 | Eligibility conflict resolved Eligibility engine | Jennifer Pena: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000826 | Eligibility conflict resolved Eligibility engine | Priya Chen: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000827 | Eligibility conflict resolved Eligibility engine | Jacob Burke: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000828 | Eligibility conflict resolved Eligibility engine | Diego Johnston: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000829 | Eligibility conflict resolved Eligibility engine | Virginia Harris: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000830 | Eligibility conflict resolved Eligibility engine | Doris Ford: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000831 | Eligibility conflict resolved Eligibility engine | Jordan Lee: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000832 | Eligibility conflict resolved Eligibility engine | Douglas Edwards: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000833 | Eligibility conflict resolved Eligibility engine | Gloria Woods: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000834 | Eligibility conflict resolved Eligibility engine | Anthony Rios: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000835 | Eligibility conflict resolved Eligibility engine | Arthur Reid: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000836 | Eligibility conflict resolved Eligibility engine | Lawrence Banks: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000837 | Eligibility conflict resolved Eligibility engine | Chris Le: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000838 | Eligibility conflict resolved Eligibility engine | Beverly Padilla: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000839 | Eligibility conflict resolved Eligibility engine | Timothy Perry: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000840 | Eligibility conflict resolved Eligibility engine | Emma Munoz: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000841 | Eligibility conflict resolved Eligibility engine | Camila Sandoval: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000842 | Eligibility conflict resolved Eligibility engine | Donald Vazquez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000843 | Eligibility conflict resolved Eligibility engine | Stephen Ray: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000844 | Eligibility conflict resolved Eligibility engine | Sarah Medina: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000845 | Eligibility conflict resolved Eligibility engine | Samantha Howard: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000846 | Eligibility conflict resolved Eligibility engine | Lawrence Russell: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000847 | Eligibility conflict resolved Eligibility engine | Joan Clark: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000848 | Eligibility conflict resolved Eligibility engine | Ruth Cole: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000849 | Eligibility conflict resolved Eligibility engine | Scott Clark: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000850 | Eligibility conflict resolved Eligibility engine | Emily Matthews: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| 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.