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-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.