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-000051 | Eligibility conflict resolved Eligibility engine | Jack Pena: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000052 | Eligibility conflict resolved Eligibility engine | Karen Harrison: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000053 | Eligibility conflict resolved Eligibility engine | Julia Le: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000054 | Eligibility conflict resolved Eligibility engine | Peggy Cooper: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000055 | Eligibility conflict resolved Eligibility engine | Julia Rice: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000056 | Eligibility conflict resolved Eligibility engine | Harold Soto: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000057 | Eligibility conflict resolved Eligibility engine | Charles Maldonado: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000058 | Eligibility conflict resolved Eligibility engine | Wei Harris: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000059 | Eligibility conflict resolved Eligibility engine | Madison Obrien: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000060 | Eligibility conflict resolved Eligibility engine | Debra Spencer: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000061 | Eligibility conflict resolved Eligibility engine | Gary Hill: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000062 | Eligibility conflict resolved Eligibility engine | Aisha Medina: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000063 | Eligibility conflict resolved Eligibility engine | Sara Kelley: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000064 | Eligibility conflict resolved Eligibility engine | Charlotte Simmons: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000065 | Eligibility conflict resolved Eligibility engine | Daniel Fuller: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000066 | Eligibility conflict resolved Eligibility engine | Martha Powell: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000067 | Eligibility conflict resolved Eligibility engine | Samuel Guerrero: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000068 | Eligibility conflict resolved Eligibility engine | Noah Franklin: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000069 | Eligibility conflict resolved Eligibility engine | Eric Morgan: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000070 | Eligibility conflict resolved Eligibility engine | Catherine Medina: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000071 | Eligibility conflict resolved Eligibility engine | Edwaard Spencer: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000072 | Eligibility conflict resolved Eligibility engine | Susan Kim: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000073 | Eligibility conflict resolved Eligibility engine | Marilyn Long: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000074 | Eligibility conflict resolved Eligibility engine | Carlos Williamson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000075 | Eligibility conflict resolved Eligibility engine | Hannah Day: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000076 | Eligibility conflict resolved Eligibility engine | Ryan Duncan: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000077 | Eligibility conflict resolved Eligibility engine | Judy Gibson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000078 | Eligibility conflict resolved Eligibility engine | Sean Castro: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000079 | Eligibility conflict resolved Eligibility engine | Abigail Hill: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000080 | Eligibility conflict resolved Eligibility engine | Heather Griffin: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000081 | Eligibility conflict resolved Eligibility engine | Hannah Burton: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000082 | Eligibility conflict resolved Eligibility engine | Aisha Ryan: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000083 | Eligibility conflict resolved Eligibility engine | James Bryant: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000084 | Eligibility conflict resolved Eligibility engine | Noah Alvarez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000085 | Eligibility conflict resolved Eligibility engine | Carl Thompson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000086 | Eligibility conflict resolved Eligibility engine | Frank Franklin: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000087 | Eligibility conflict resolved Eligibility engine | Frances Bailey: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000088 | Eligibility conflict resolved Eligibility engine | Valentina Warren: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000089 | Eligibility conflict resolved Eligibility engine | Carl Kennedy: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000090 | Eligibility conflict resolved Eligibility engine | Peter Gilbert: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000091 | Eligibility conflict resolved Eligibility engine | Brittany Mendez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000092 | Eligibility conflict resolved Eligibility engine | Dennis Dunn: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000093 | Eligibility conflict resolved Eligibility engine | Alexis Olson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000094 | Eligibility conflict resolved Eligibility engine | Betty Cooper: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000095 | Eligibility conflict resolved Eligibility engine | John Ramos: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000096 | Eligibility conflict resolved Eligibility engine | Scott Scott: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000097 | Eligibility conflict resolved Eligibility engine | Megan Rice: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000098 | Eligibility conflict resolved Eligibility engine | Gary Hughes: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000099 | Eligibility conflict resolved Eligibility engine | Julia Soot: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000100 | Eligibility conflict resolved Eligibility engine | Jordan Padilla: 2 plan codes across sources → canonical NAVIGATE-HMO |
| 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.