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-000951 | Eligibility conflict resolved Eligibility engine | Webb Webb: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000952 | Eligibility conflict resolved Eligibility engine | Katherine Daniels: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000953 | Eligibility conflict resolved Eligibility engine | Virginia Hayes: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000954 | Eligibility conflict resolved Eligibility engine | Logan Carpenter: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000955 | Eligibility conflict resolved Eligibility engine | Donald Castillo: 3 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000956 | Eligibility conflict resolved Eligibility engine | Luis Reynolds: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000957 | Eligibility conflict resolved Eligibility engine | Brittany Griffin: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000958 | Eligibility conflict resolved Eligibility engine | Gerald Burns: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000959 | Eligibility conflict resolved Eligibility engine | Joseph Wang: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000960 | Eligibility conflict resolved Eligibility engine | Janet Wood: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000961 | Eligibility conflict resolved Eligibility engine | Sarah Crawford: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000962 | Eligibility conflict resolved Eligibility engine | Olivia Bradley: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000963 | Eligibility conflict resolved Eligibility engine | David Henry: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000964 | Eligibility conflict resolved Eligibility engine | Bradley Flores: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000965 | Eligibility conflict resolved Eligibility engine | Heather Moreno: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000966 | Eligibility conflict resolved Eligibility engine | Ruth Robertson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000967 | Eligibility conflict resolved Eligibility engine | Peter Brooks: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000968 | Eligibility conflict resolved Eligibility engine | Frank Fernandez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000969 | Eligibility conflict resolved Eligibility engine | Barbara Long: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000970 | Eligibility conflict resolved Eligibility engine | Christian Gibson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000971 | Eligibility conflict resolved Eligibility engine | Brenda Lewis: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000972 | Eligibility conflict resolved Eligibility engine | Ann Gonzalez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000973 | Eligibility conflict resolved Eligibility engine | Judith Guzman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000974 | Eligibility conflict resolved Eligibility engine | Camila Shaw: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000975 | Eligibility conflict resolved Eligibility engine | Kevin Johnston: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000976 | Eligibility conflict resolved Eligibility engine | Ahmed Hudson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000977 | Eligibility conflict resolved Eligibility engine | Jacqueline Spencer: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000978 | Eligibility conflict resolved Eligibility engine | Joseph King: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000979 | Eligibility conflict resolved Eligibility engine | Cooper Justin: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000980 | Eligibility conflict resolved Eligibility engine | Dennis Salazar: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000981 | Eligibility conflict resolved Eligibility engine | Shirley Watson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000982 | Eligibility conflict resolved Eligibility engine | Mariana Moreno: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000983 | Eligibility conflict resolved Eligibility engine | Douglas Cruz: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000984 | Eligibility conflict resolved Eligibility engine | Brian Reed: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000985 | Eligibility conflict resolved Eligibility engine | Zachary Simpson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000986 | Eligibility conflict resolved Eligibility engine | Philip Fergusson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000987 | Eligibility conflict resolved Eligibility engine | Carl Barnes: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000988 | Eligibility conflict resolved Eligibility engine | Barbara Gibson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000989 | Eligibility conflict resolved Eligibility engine | Mason Gomez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000990 | Eligibility conflict resolved Eligibility engine | Ahmed Patel: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000991 | Eligibility conflict resolved Eligibility engine | Terry Cunningham: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000992 | Eligibility conflict resolved Eligibility engine | Heather Arnold: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000993 | Eligibility conflict resolved Eligibility engine | Virginia Bowman: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000994 | Eligibility conflict resolved Eligibility engine | Walter Andrews: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000995 | Eligibility conflict resolved Eligibility engine | Ann Wilson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000996 | Eligibility conflict resolved Eligibility engine | Evelyn Johnston: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000997 | Eligibility conflict resolved Eligibility engine | Alan Washington: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000998 | Eligibility conflict resolved Eligibility engine | Emma Tucker: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000999 | Eligibility conflict resolved Eligibility engine | Lisa Morris: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001000 | Eligibility conflict resolved Eligibility engine | Anthony Weber: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| 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.