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-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.