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-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.