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-001151 | Eligibility conflict resolved Eligibility engine | Gregory Gutierrez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001152 | Eligibility conflict resolved Eligibility engine | Laura Roberts: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001153 | Eligibility conflict resolved Eligibility engine | Mateo Perkins: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001154 | Eligibility conflict resolved Eligibility engine | Frank Williamson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001155 | Eligibility conflict resolved Eligibility engine | Randy Ward: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001156 | Eligibility conflict resolved Eligibility engine | Priya Weest: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001157 | Eligibility conflict resolved Eligibility engine | Kathryn Lawrence: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001158 | Eligibility conflict resolved Eligibility engine | Jesse Santos: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001159 | Eligibility conflict resolved Eligibility engine | Diego George: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001160 | Eligibility conflict resolved Eligibility engine | Camila Brown: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001161 | Eligibility conflict resolved Eligibility engine | Dylan Hill: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001162 | Eligibility conflict resolved Eligibility engine | James Ruiz: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001163 | Eligibility conflict resolved Eligibility engine | Abigail Carr: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001164 | Eligibility conflict resolved Eligibility engine | Mark Palmer: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001165 | Eligibility conflict resolved Eligibility engine | Mark Lopez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001166 | Eligibility conflict resolved Eligibility engine | Benjamin Henry: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001167 | Eligibility conflict resolved Eligibility engine | Robert Collins: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001168 | Eligibility conflict resolved Eligibility engine | Donna Allen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001169 | Eligibility conflict resolved Eligibility engine | Cheryl Garza: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001170 | Eligibility conflict resolved Eligibility engine | Bradley Armstrong: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001171 | Eligibility conflict resolved Eligibility engine | Abigail Montgomery: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001172 | Eligibility conflict resolved Eligibility engine | Marcus Hudson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001173 | Eligibility conflict resolved Eligibility engine | Theresa Hoffman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001174 | Eligibility conflict resolved Eligibility engine | Mason Lawrence: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001175 | Eligibility conflict resolved Eligibility engine | Kim Harvey: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001176 | Eligibility conflict resolved Eligibility engine | Chris Baker: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001177 | Eligibility conflict resolved Eligibility engine | Mariana Reynolds: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001178 | Eligibility conflict resolved Eligibility engine | Lucia Robertson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001179 | Eligibility conflict resolved Eligibility engine | Doris West: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001180 | Eligibility conflict resolved Eligibility engine | Peter Austin: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001181 | Eligibility conflict resolved Eligibility engine | Gregory Boyd: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001182 | Eligibility conflict resolved Eligibility engine | Sean Kelly: 3 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001183 | Eligibility conflict resolved Eligibility engine | Linda Johnson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001184 | Eligibility conflict resolved Eligibility engine | Doris Welch: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001185 | Eligibility conflict resolved Eligibility engine | William Stone: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001186 | Eligibility conflict resolved Eligibility engine | Thomas Barnes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001187 | Eligibility conflict resolved Eligibility engine | Carol Moore: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001188 | Eligibility conflict resolved Eligibility engine | Michelle Bryant: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001189 | Eligibility conflict resolved Eligibility engine | Timothy Howell: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001190 | Eligibility conflict resolved Eligibility engine | Frances Ross: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001191 | Eligibility conflict resolved Eligibility engine | Pamela Richards: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001192 | Eligibility conflict resolved Eligibility engine | Ronald Brooks: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001193 | Eligibility conflict resolved Eligibility engine | Ana Mejia: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001194 | Eligibility conflict resolved Eligibility engine | Stephen Graham: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001195 | Eligibility conflict resolved Eligibility engine | Keith Morales: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001196 | Eligibility conflict resolved Eligibility engine | Doris Matthews: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001197 | Eligibility conflict resolved Eligibility engine | Brenda Obrien: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001198 | Eligibility conflict resolved Eligibility engine | Kayla Wagner: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001199 | Eligibility conflict resolved Eligibility engine | Gary Vargas: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001200 | Eligibility conflict resolved Eligibility engine | Evelyn Kim: 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.