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-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.