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-001051 | Eligibility conflict resolved Eligibility engine | Virginia Freeman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001052 | Eligibility conflict resolved Eligibility engine | Amy Rice: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001053 | Eligibility conflict resolved Eligibility engine | Carl Murray: 3 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001054 | Eligibility conflict resolved Eligibility engine | Lisa Nunez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001055 | Eligibility conflict resolved Eligibility engine | Susan Morrison: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001056 | Eligibility conflict resolved Eligibility engine | Kelly Keley: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001057 | Eligibility conflict resolved Eligibility engine | Denise Williams: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001058 | Eligibility conflict resolved Eligibility engine | Theresa Kelly: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001059 | Eligibility conflict resolved Eligibility engine | Noah Burton: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001060 | Eligibility conflict resolved Eligibility engine | George Garza: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001061 | Eligibility conflict resolved Eligibility engine | Shirley Phillips: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001062 | Eligibility conflict resolved Eligibility engine | Jessica Hart: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001063 | Eligibility conflict resolved Eligibility engine | Valentina Duncan: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001064 | Eligibility conflict resolved Eligibility engine | Bradley Barnes: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001065 | Eligibility conflict resolved Eligibility engine | Melissa Campbell: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001066 | Eligibility conflict resolved Eligibility engine | Gloria Dominguez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001067 | Eligibility conflict resolved Eligibility engine | Willie Chavez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001068 | Eligibility conflict resolved Eligibility engine | Bruce Meyer: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001069 | Eligibility conflict resolved Eligibility engine | Ruth Flores: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001070 | Eligibility conflict resolved Eligibility engine | Judith Rivera: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001071 | Eligibility conflict resolved Eligibility engine | Alan Brown: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001072 | Eligibility conflict resolved Eligibility engine | Susan Schmidt: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001073 | Eligibility conflict resolved Eligibility engine | Henry Chen: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001074 | Eligibility conflict resolved Eligibility engine | Ann Castro: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001075 | Eligibility conflict resolved Eligibility engine | Austin Cook: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001076 | Eligibility conflict resolved Eligibility engine | Benjamin McCoy: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001077 | Eligibility conflict resolved Eligibility engine | Angela George: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001078 | Eligibility conflict resolved Eligibility engine | Alexander Turner: 3 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001079 | Eligibility conflict resolved Eligibility engine | Kyle Carr: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001080 | Eligibility conflict resolved Eligibility engine | Lauren Johnston: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001081 | Eligibility conflict resolved Eligibility engine | Sofia Owens: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001082 | Eligibility conflict resolved Eligibility engine | Ronald Stone: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001083 | Eligibility conflict resolved Eligibility engine | Deborah Baker: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001084 | Eligibility conflict resolved Eligibility engine | Joseph Riley: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001085 | Eligibility conflict resolved Eligibility engine | Deborah Evans: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001086 | Eligibility conflict resolved Eligibility engine | Donna Crawford: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001087 | Eligibility conflict resolved Eligibility engine | Donna Ramos: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001088 | Eligibility conflict resolved Eligibility engine | Joan Meyer: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001089 | Eligibility conflict resolved Eligibility engine | Brian Arnold: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001090 | Eligibility conflict resolved Eligibility engine | Juan McCoy: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001091 | Eligibility conflict resolved Eligibility engine | Noha Nichols: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001092 | Eligibility conflict resolved Eligibility engine | Margaret Kelley: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001093 | Eligibility conflict resolved Eligibility engine | Doris Kelly: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001094 | Eligibility conflict resolved Eligibility engine | Janice Walsh: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001095 | Eligibility conflict resolved Eligibility engine | Roger Wheeler: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001096 | Eligibility conflict resolved Eligibility engine | Greg Luna: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001097 | Eligibility conflict resolved Eligibility engine | Kathy Watkins: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001098 | Eligibility conflict resolved Eligibility engine | Noah Weaver: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001099 | Eligibility conflict resolved Eligibility engine | Amy Fernandez: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001100 | Eligibility conflict resolved Eligibility engine | Margaret Margaret: 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.