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-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.