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-001251 | Eligibility conflict resolved Eligibility engine | Melissa Welch: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001252 | Eligibility conflict resolved Eligibility engine | Jose Dixon: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001253 | Eligibility conflict resolved Eligibility engine | Herold Arnold: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001254 | Eligibility conflict resolved Eligibility engine | Jacqueline Singh: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001255 | Eligibility conflict resolved Eligibility engine | Joe Reid: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001256 | Eligibility conflict resolved Eligibility engine | Tyler Henry: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001257 | Eligibility conflict resolved Eligibility engine | Yuki Ruiz: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001258 | Eligibility conflict resolved Eligibility engine | Aaron Andrews: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001259 | Eligibility conflict resolved Eligibility engine | Matthew Howell: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001260 | Eligibility conflict resolved Eligibility engine | Ann Morgan: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001261 | Eligibility conflict resolved Eligibility engine | Sean Sims: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001262 | Eligibility conflict resolved Eligibility engine | Kathryn Kelley: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001263 | Eligibility conflict resolved Eligibility engine | Margaret Yang: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001264 | Eligibility conflict resolved Eligibility engine | Jerry Stevens: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001265 | Eligibility conflict resolved Eligibility engine | Eugene Edwards: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001266 | Eligibility conflict resolved Eligibility engine | Laura Ramirez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001267 | Eligibility conflict resolved Eligibility engine | Edward Jensen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001268 | Eligibility conflict resolved Eligibility engine | Brian Carter: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001269 | Eligibility conflict resolved Eligibility engine | Amanda Price: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001270 | Eligibility conflict resolved Eligibility engine | Julia Banks: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001271 | Eligibility conflict resolved Eligibility engine | Carl Watson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001272 | Eligibility conflict resolved Eligibility engine | Nick Fuller: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001273 | Eligibility conflict resolved Eligibility engine | Marilyn Hayes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001274 | Eligibility conflict resolved Eligibility engine | James Cooper: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001275 | Eligibility conflict resolved Eligibility engine | Frank Li: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001276 | Eligibility conflict resolved Eligibility engine | Arjun Hughes: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001277 | Eligibility conflict resolved Eligibility engine | Russell Hart: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001278 | Eligibility conflict resolved Eligibility engine | Evelyn Elliott: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001279 | Eligibility conflict resolved Eligibility engine | Alexander Moore: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001280 | Eligibility conflict resolved Eligibility engine | Raymond Maldonado: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001281 | Eligibility conflict resolved Eligibility engine | Rebecca Park: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001282 | Eligibility conflict resolved Eligibility engine | Hiroshi Hamilton: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001283 | Eligibility conflict resolved Eligibility engine | Katherine Knight: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001284 | Eligibility conflict resolved Eligibility engine | Charlotte Gomez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001285 | Eligibility conflict resolved Eligibility engine | Jeremy Campbell: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001286 | Eligibility conflict resolved Eligibility engine | Julia Hunt: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001287 | Eligibility conflict resolved Eligibility engine | Kimberly Hernandez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001288 | Eligibility conflict resolved Eligibility engine | Priya Reid: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001289 | Eligibility conflict resolved Eligibility engine | Carolyn Green: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001290 | Eligibility conflict resolved Eligibility engine | Eugene Contreras: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001291 | Eligibility conflict resolved Eligibility engine | Frank Alvarez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001292 | Eligibility conflict resolved Eligibility engine | Terry Olson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001293 | Eligibility conflict resolved Eligibility engine | Nicole Hayes: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001294 | Eligibility conflict resolved Eligibility engine | Janet Knight: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001295 | Eligibility conflict resolved Eligibility engine | Robert Jenkins: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001296 | Eligibility conflict resolved Eligibility engine | Charlotte Delgado: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001297 | Eligibility conflict resolved Eligibility engine | Benjamin Luna: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001298 | Eligibility conflict resolved Eligibility engine | Jerry Williamson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001299 | Eligibility conflict resolved Eligibility engine | Ronald Howard: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001300 | Eligibility conflict resolved Eligibility engine | Arjun Valdez: 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.