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-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.