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-001001 | Eligibility conflict resolved Eligibility engine | Luis Pena: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001002 | Eligibility conflict resolved Eligibility engine | Danielle Day: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001003 | Eligibility conflict resolved Eligibility engine | Cheryl McDonald: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001004 | Eligibility conflict resolved Eligibility engine | Marcus Hart: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001005 | Eligibility conflict resolved Eligibility engine | Aisha McCoy: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001006 | Eligibility conflict resolved Eligibility engine | Larry Campbell: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001007 | Eligibility conflict resolved Eligibility engine | Matthew Long: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001008 | Eligibility conflict resolved Eligibility engine | Fatima Robertson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001009 | Eligibility conflict resolved Eligibility engine | Kevin Garcia: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001010 | Eligibility conflict resolved Eligibility engine | Robert Thomas: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001011 | Eligibility conflict resolved Eligibility engine | Brenda Bradley: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001012 | Eligibility conflict resolved Eligibility engine | Carol Rose: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001013 | Eligibility conflict resolved Eligibility engine | Timothy Griffin: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001014 | Eligibility conflict resolved Eligibility engine | Mei King: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001015 | Eligibility conflict resolved Eligibility engine | Carolyn Martin: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001016 | Eligibility conflict resolved Eligibility engine | Christopher Yang: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001017 | Eligibility conflict resolved Eligibility engine | Amanda Arnold: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001018 | Eligibility conflict resolved Eligibility engine | Shirley Harrison: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001019 | Eligibility conflict resolved Eligibility engine | Eric Rojas: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001020 | Eligibility conflict resolved Eligibility engine | Christine Elliott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001021 | Eligibility conflict resolved Eligibility engine | Omar Moore: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001022 | Eligibility conflict resolved Eligibility engine | Logan Lucas: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001023 | Eligibility conflict resolved Eligibility engine | Kenneth Henry: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001024 | Eligibility conflict resolved Eligibility engine | Jack Sims: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001025 | Eligibility conflict resolved Eligibility engine | Eugene Adams: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001026 | Eligibility conflict resolved Eligibility engine | Adam Turner: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001027 | Eligibility conflict resolved Eligibility engine | Carolyn Hunter: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001028 | Eligibility conflict resolved Eligibility engine | Sharon Simmons: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001029 | Eligibility conflict resolved Eligibility engine | Joseph Ortiz: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001030 | Eligibility conflict resolved Eligibility engine | Marilyn James: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001031 | Eligibility conflict resolved Eligibility engine | Christina Mitchell: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001032 | Eligibility conflict resolved Eligibility engine | Kelly Griffin: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001033 | Eligibility conflict resolved Eligibility engine | Jose Pena: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001034 | Eligibility conflict resolved Eligibility engine | Rebecca Fox: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001035 | Eligibility conflict resolved Eligibility engine | Robert Ray: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001036 | Eligibility conflict resolved Eligibility engine | Lori Carlson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001037 | Eligibility conflict resolved Eligibility engine | Patricia Richards: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001038 | Eligibility conflict resolved Eligibility engine | Jason Nelson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001039 | Eligibility conflict resolved Eligibility engine | Jeremy Owens: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001040 | Eligibility conflict resolved Eligibility engine | Andrew Dominguez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001041 | Eligibility conflict resolved Eligibility engine | Nicholas Sullivan: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001042 | Eligibility conflict resolved Eligibility engine | Philip Dean: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001043 | Eligibility conflict resolved Eligibility engine | Donna Gutierrez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001044 | Eligibility conflict resolved Eligibility engine | Pamela Morrison: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001045 | Eligibility conflict resolved Eligibility engine | Edward Boyd: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001046 | Eligibility conflict resolved Eligibility engine | Jannice Schulltz: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001047 | Eligibility conflict resolved Eligibility engine | Marilyn Carpneter: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001048 | Eligibility conflict resolved Eligibility engine | Christopher Coleman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001049 | Eligibility conflict resolved Eligibility engine | David Green: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001050 | Eligibility conflict resolved Eligibility engine | Joan Garcia: 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.