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-000851 | Eligibility conflict resolved Eligibility engine | Rebecca Hamilton: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000852 | Eligibility conflict resolved Eligibility engine | Pamela Little: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000853 | Eligibility conflict resolved Eligibility engine | Watson Steven: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000854 | Eligibility conflict resolved Eligibility engine | Elijah Hunter: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000855 | Eligibility conflict resolved Eligibility engine | Stephen Grant: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000856 | Eligibility conflict resolved Eligibility engine | Nicole Banks: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000857 | Eligibility conflict resolved Eligibility engine | Raymond Baker: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000858 | Eligibility conflict resolved Eligibility engine | Christopher Hawkins: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000859 | Eligibility conflict resolved Eligibility engine | Martha Haimlton: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000860 | Eligibility conflict resolved Eligibility engine | Brian Cunningham: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000861 | Eligibility conflict resolved Eligibility engine | Kyle Nelson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000862 | Eligibility conflict resolved Eligibility engine | Sandra Spencer: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000863 | Eligibility conflict resolved Eligibility engine | Danielle Young: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000864 | Eligibility conflict resolved Eligibility engine | Beverly Rogers: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000865 | Eligibility conflict resolved Eligibility engine | Michael Lucas: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000866 | Eligibility conflict resolved Eligibility engine | Carol Burton: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000867 | Eligibility conflict resolved Eligibility engine | Ahmed Ferguson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000868 | Eligibility conflict resolved Eligibility engine | Christina Bowman: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000869 | Eligibility conflict resolved Eligibility engine | Mei Bradley: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000870 | Eligibility conflict resolved Eligibility engine | Abigail Vasquez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000871 | Eligibility conflict resolved Eligibility engine | Jacob Turner: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000872 | Eligibility conflict resolved Eligibility engine | Jacqueline Patel: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000873 | Eligibility conflict resolved Eligibility engine | Ana Robinson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000874 | Eligibility conflict resolved Eligibility engine | Abigail Allen: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000875 | Eligibility conflict resolved Eligibility engine | Priya Thompson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000876 | Eligibility conflict resolved Eligibility engine | Emma Hunt: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000877 | Eligibility conflict resolved Eligibility engine | Yuki Willis: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000878 | Eligibility conflict resolved Eligibility engine | Wei Avlarez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000879 | Eligibility conflict resolved Eligibility engine | Kenneth Stewart: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000880 | Eligibility conflict resolved Eligibility engine | Vincent Hernandez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000881 | Eligibility conflict resolved Eligibility engine | Santiago Garza: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000882 | Eligibility conflict resolved Eligibility engine | Daniel Reid: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000883 | Eligibility conflict resolved Eligibility engine | Ana Santos: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000884 | Eligibility conflict resolved Eligibility engine | Robert Hunter: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000885 | Eligibility conflict resolved Eligibility engine | Zachary Wheeler: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000886 | Eligibility conflict resolved Eligibility engine | Maria Myers: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000887 | Eligibility conflict resolved Eligibility engine | Austin Frnklin: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000888 | Eligibility conflict resolved Eligibility engine | Fatima Espinoza: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000889 | Eligibility conflict resolved Eligibility engine | Yuki Nguyen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000890 | Eligibility conflict resolved Eligibility engine | Arthur Lucas: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000891 | Eligibility conflict resolved Eligibility engine | Mei Jordan: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000892 | Eligibility conflict resolved Eligibility engine | Jeremy Hanson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000893 | Eligibility conflict resolved Eligibility engine | Ann Le: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000894 | Eligibility conflict resolved Eligibility engine | Austin Yang: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000895 | Eligibility conflict resolved Eligibility engine | Vincent Austin: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000896 | Eligibility conflict resolved Eligibility engine | Brittany Fowler: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000897 | Eligibility conflict resolved Eligibility engine | Donald Gomez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000898 | Eligibility conflict resolved Eligibility engine | Kimberly Ramirez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000899 | Eligibility conflict resolved Eligibility engine | Sharon Salazar: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000900 | Eligibility conflict resolved Eligibility engine | Hiroshi Kelley: 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.