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-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.