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-001201 | Eligibility conflict resolved Eligibility engine | Jennifer Martinez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001202 | Eligibility conflict resolved Eligibility engine | Heather Lopez: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001203 | Eligibility conflict resolved Eligibility engine | Anna Espinoza: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001204 | Eligibility conflict resolved Eligibility engine | Amy Marshall: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001205 | Eligibility conflict resolved Eligibility engine | Stephanie Henderson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001206 | Eligibility conflict resolved Eligibility engine | Emma Hill: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001207 | Eligibility conflict resolved Eligibility engine | Gary Burns: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001208 | Eligibility conflict resolved Eligibility engine | Rebecca Schultz: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001209 | Eligibility conflict resolved Eligibility engine | Kathleen Luna: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001210 | Eligibility conflict resolved Eligibility engine | Mei Long: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001211 | Eligibility conflict resolved Eligibility engine | Angela Nelson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001212 | Eligibility conflict resolved Eligibility engine | Lawrence Gibson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001213 | Eligibility conflict resolved Eligibility engine | Judith Myers: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001214 | Eligibility conflict resolved Eligibility engine | Janice Butler: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001215 | Eligibility conflict resolved Eligibility engine | Matthew Bailey: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001216 | Eligibility conflict resolved Eligibility engine | Evelyn Ortega: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001217 | Eligibility conflict resolved Eligibility engine | Christian Ruiz: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001218 | Eligibility conflict resolved Eligibility engine | Barbara Stevens: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001219 | Eligibility conflict resolved Eligibility engine | Jean Bell: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001220 | Eligibility conflict resolved Eligibility engine | Janet Reyes: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001221 | Eligibility conflict resolved Eligibility engine | Sarah Weaver: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001222 | Eligibility conflict resolved Eligibility engine | Patricia Hart: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001223 | Eligibility conflict resolved Eligibility engine | Sofia Obrien: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001224 | Eligibility conflict resolved Eligibility engine | Omar Vazquez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001225 | Eligibility conflict resolved Eligibility engine | Bradley Matthews: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001226 | Eligibility conflict resolved Eligibility engine | Diana Hanson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001227 | Eligibility conflict resolved Eligibility engine | Shirley Rojas: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001228 | Eligibility conflict resolved Eligibility engine | Billy Weaver: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001229 | Eligibility conflict resolved Eligibility engine | Denise Guerrero: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001230 | Eligibility conflict resolved Eligibility engine | Brenda Tucker: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001231 | Eligibility conflict resolved Eligibility engine | Julie Nelson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001232 | Eligibility conflict resolved Eligibility engine | Frances Espinoza: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001233 | Eligibility conflict resolved Eligibility engine | Valentina Matthews: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001234 | Eligibility conflict resolved Eligibility engine | Dylan Scott: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001235 | Eligibility conflict resolved Eligibility engine | Jack Bishop: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001236 | Eligibility conflict resolved Eligibility engine | Jacob Snyder: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001237 | Eligibility conflict resolved Eligibility engine | Martha Estrada: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001238 | Eligibility conflict resolved Eligibility engine | Carl Pena: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001239 | Eligibility conflict resolved Eligibility engine | Cynthia Mejia: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001240 | Eligibility conflict resolved Eligibility engine | Mei Obrien: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001241 | Eligibility conflict resolved Eligibility engine | Gloria Chapman: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001242 | Eligibility conflict resolved Eligibility engine | Diane Lewis: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001243 | Eligibility conflict resolved Eligibility engine | Christopher Thompson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001244 | Eligibility conflict resolved Eligibility engine | Mei Alexander: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001245 | Eligibility conflict resolved Eligibility engine | Susan Estrada: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001246 | Eligibility conflict resolved Eligibility engine | Jonathan Tucker: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001247 | Eligibility conflict resolved Eligibility engine | Eugene Davis: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001248 | Eligibility conflict resolved Eligibility engine | Noah Torres: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001249 | Eligibility conflict resolved Eligibility engine | Gloria Dean: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001250 | Eligibility conflict resolved Eligibility engine | Alice Larson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| 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.