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-001101 | Eligibility conflict resolved Eligibility engine | Ronald Valdez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001102 | Eligibility conflict resolved Eligibility engine | Hiroshi Li: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001103 | Eligibility conflict resolved Eligibility engine | Hannah Ramos: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001104 | Eligibility conflict resolved Eligibility engine | Charles Marquez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001105 | Eligibility conflict resolved Eligibility engine | Anthony Harper: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001106 | Eligibility conflict resolved Eligibility engine | Abigail Dunn: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001107 | Eligibility conflict resolved Eligibility engine | Jessica Smith: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001108 | Eligibility conflict resolved Eligibility engine | Gary Morgan: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001109 | Eligibility conflict resolved Eligibility engine | Dorothy Rivera: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001110 | Eligibility conflict resolved Eligibility engine | Santiago Rivera: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001111 | Eligibility conflict resolved Eligibility engine | Gloria Martinez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001112 | Eligibility conflict resolved Eligibility engine | Abigail Spencer: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001113 | Eligibility conflict resolved Eligibility engine | Thomas Morales: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001114 | Eligibility conflict resolved Eligibility engine | Angela Harrison: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001115 | Eligibility conflict resolved Eligibility engine | Carolyn Aguilar: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001116 | Eligibility conflict resolved Eligibility engine | Cynthia Porter: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001117 | Eligibility conflict resolved Eligibility engine | Jonathan Sandoval: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001118 | Eligibility conflict resolved Eligibility engine | Judy Perez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001119 | Eligibility conflict resolved Eligibility engine | Lucia Watson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001120 | Eligibility conflict resolved Eligibility engine | Rebecca Harrison: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001121 | Eligibility conflict resolved Eligibility engine | Zachary Singh: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001122 | Eligibility conflict resolved Eligibility engine | Julia Daniels: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001123 | Eligibility conflict resolved Eligibility engine | Alexis Howell: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001124 | Eligibility conflict resolved Eligibility engine | Denise Stephens: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001125 | Eligibility conflict resolved Eligibility engine | Paul Vazquez: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001126 | Eligibility conflict resolved Eligibility engine | Rachel Hart: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001127 | Eligibility conflict resolved Eligibility engine | Priya Ortiz: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001128 | Eligibility conflict resolved Eligibility engine | Brian Rogers: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001129 | Eligibility conflict resolved Eligibility engine | Bryan Stevens: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001130 | Eligibility conflict resolved Eligibility engine | Jessica Simpson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001131 | Eligibility conflict resolved Eligibility engine | Angela Guzman: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001132 | Eligibility conflict resolved Eligibility engine | Ethan Chavez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001133 | Eligibility conflict resolved Eligibility engine | Stephen Garza: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001134 | Eligibility conflict resolved Eligibility engine | Gabriel Price: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001135 | Eligibility conflict resolved Eligibility engine | Lucia Jenkins: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001136 | Eligibility conflict resolved Eligibility engine | Jacob Brown: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001137 | Eligibility conflict resolved Eligibility engine | Kyle Harvey: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001138 | Eligibility conflict resolved Eligibility engine | Anna Bowman: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001139 | Eligibility conflict resolved Eligibility engine | Douglas Cook: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001140 | Eligibility conflict resolved Eligibility engine | Ashley Hunt: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001141 | Eligibility conflict resolved Eligibility engine | Adam Green: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001142 | Eligibility conflict resolved Eligibility engine | Walter Salazar: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001143 | Eligibility conflict resolved Eligibility engine | Carol Murray: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001144 | Eligibility conflict resolved Eligibility engine | Juan Alvarez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001145 | Eligibility conflict resolved Eligibility engine | Brenda Estrada: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001146 | Eligibility conflict resolved Eligibility engine | Douglas Fox: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001147 | Eligibility conflict resolved Eligibility engine | Donald Ray: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001148 | Eligibility conflict resolved Eligibility engine | Beverly Carlson: 3 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001149 | Eligibility conflict resolved Eligibility engine | Carlos Ryan: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001150 | Eligibility conflict resolved Eligibility engine | Justin Ortiz: 2 plan codes across sources → canonical SELECT-EPO |
| 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.