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-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.