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-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.