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-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.