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-000901 | Eligibility conflict resolved Eligibility engine | Vincent Castillo: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000902 | Eligibility conflict resolved Eligibility engine | Joshua Vargas: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000903 | Eligibility conflict resolved Eligibility engine | Barbara McDonald: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000904 | Eligibility conflict resolved Eligibility engine | Timothy Soto: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000905 | Eligibility conflict resolved Eligibility engine | Austin Broooks: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000906 | Eligibility conflict resolved Eligibility engine | Peter Patel: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000907 | Eligibility conflict resolved Eligibility engine | Madison Russell: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000908 | Eligibility conflict resolved Eligibility engine | Arthur George: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000909 | Eligibility conflict resolved Eligibility engine | Sandra Brown: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000910 | Eligibility conflict resolved Eligibility engine | Deborah Maldonado: 3 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000911 | Eligibility conflict resolved Eligibility engine | Janice Bradley: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000912 | Eligibility conflict resolved Eligibility engine | Wei Fuller: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000913 | Eligibility conflict resolved Eligibility engine | Ralph Hicks: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000914 | Eligibility conflict resolved Eligibility engine | Kevin Gordon: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000915 | Eligibility conflict resolved Eligibility engine | Eric Freeman: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000916 | Eligibility conflict resolved Eligibility engine | Kimberly Robinson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000917 | Eligibility conflict resolved Eligibility engine | Sarah Long: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000918 | Eligibility conflict resolved Eligibility engine | Hiroshi Russell: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000919 | Eligibility conflict resolved Eligibility engine | Sandra Peterson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000920 | Eligibility conflict resolved Eligibility engine | Henry Reynolds: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000921 | Eligibility conflict resolved Eligibility engine | Vincent West: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000922 | Eligibility conflict resolved Eligibility engine | David Hansen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000923 | Eligibility conflict resolved Eligibility engine | Diego Castillo: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000924 | Eligibility conflict resolved Eligibility engine | Sandra Soto: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000925 | Eligibility conflict resolved Eligibility engine | Edward Ward: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000926 | Eligibility conflict resolved Eligibility engine | Alan Ryan: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000927 | Eligibility conflict resolved Eligibility engine | Valentina Perry: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000928 | Eligibility conflict resolved Eligibility engine | Gregory Wagner: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000929 | Eligibility conflict resolved Eligibility engine | Priya Lopez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000930 | Eligibility conflict resolved Eligibility engine | Gay Hansen: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000931 | Eligibility conflict resolved Eligibility engine | Henry Yang: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000932 | Eligibility conflict resolved Eligibility engine | Thomas Campbell: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000933 | Eligibility conflict resolved Eligibility engine | Charles Jimenez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000934 | Eligibility conflict resolved Eligibility engine | Isabella Vargas: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000935 | Eligibility conflict resolved Eligibility engine | Jacqueline Johnston: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000936 | Eligibility conflict resolved Eligibility engine | Seaan Price: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000937 | Eligibility conflict resolved Eligibility engine | Dorothy Russell: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000938 | Eligibility conflict resolved Eligibility engine | Wayne Armstrong: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000939 | Eligibility conflict resolved Eligibility engine | Joyce Tran: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000940 | Eligibility conflict resolved Eligibility engine | Keith Collins: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000941 | Eligibility conflict resolved Eligibility engine | Juan Mills: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000942 | Eligibility conflict resolved Eligibility engine | Amber Powll: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000943 | Eligibility conflict resolved Eligibility engine | Rebecca Gonzalez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000944 | Eligibility conflict resolved Eligibility engine | Anthony Jackson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000945 | Eligibility conflict resolved Eligibility engine | Diane Gordon: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000946 | Eligibility conflict resolved Eligibility engine | Amanda Campbell: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000947 | Eligibility conflict resolved Eligibility engine | Maria Nguyen: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000948 | Eligibility conflict resolved Eligibility engine | Sofia Thompson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000949 | Eligibility conflict resolved Eligibility engine | Priya Ortega: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000950 | Eligibility conflict resolved Eligibility engine | Joan Weaver: 2 plan codes across sources → canonical OPTIONS-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.