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-001301 | Eligibility conflict resolved Eligibility engine | Beverly Hughes: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001302 | Eligibility conflict resolved Eligibility engine | Betty Martinez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001303 | Eligibility conflict resolved Eligibility engine | Paul Nguyen: 3 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001304 | Eligibility conflict resolved Eligibility engine | Juhn Simpson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001305 | Eligibility conflict resolved Eligibility engine | Carl Ruiz: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001306 | Eligibility conflict resolved Eligibility engine | Kennteh Flores: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001307 | Eligibility conflict resolved Eligibility engine | Grace Johnston: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001308 | Eligibility conflict resolved Eligibility engine | Marcus Ford: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001309 | Eligibility conflict resolved Eligibility engine | Kyle Silva: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001310 | Eligibility conflict resolved Eligibility engine | Nicholas Le: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001311 | Eligibility conflict resolved Eligibility engine | Isabella Andrews: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001312 | Eligibility conflict resolved Eligibility engine | Isabella Carter: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001313 | Eligibility conflict resolved Eligibility engine | Mei Robertson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001314 | Eligibility conflict resolved Eligibility engine | Ronald Lawrence: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001315 | Eligibility conflict resolved Eligibility engine | Amanda Daniels: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001316 | Eligibility conflict resolved Eligibility engine | Jimmy Guzman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001317 | Eligibility conflict resolved Eligibility engine | Abby Woods: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001318 | Eligibility conflict resolved Eligibility engine | Madison Foster: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001319 | Eligibility conflict resolved Eligibility engine | Nancy Patel: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001320 | Eligibility conflict resolved Eligibility engine | Justin Brooks: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001321 | Eligibility conflict resolved Eligibility engine | Nancy Wallace: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001322 | Eligibility conflict resolved Eligibility engine | Benjamin Ward: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001323 | Eligibility conflict resolved Eligibility engine | Matthew Chavez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001324 | Eligibility conflict resolved Eligibility engine | Janice Rojes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001325 | Eligibility conflict resolved Eligibility engine | Betty Fox: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001326 | Eligibility conflict resolved Eligibility engine | Carolyn Wheeler: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001327 | Eligibility conflict resolved Eligibility engine | Marcus Jimenez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001328 | Eligibility conflict resolved Eligibility engine | Henry Chen: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-001329 | Eligibility conflict resolved Eligibility engine | Samantha Fowler: 3 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001330 | Eligibility conflict resolved Eligibility engine | Diana Hernandez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001331 | Eligibility conflict resolved Eligibility engine | Jesse Berry: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-001332 | Eligibility conflict resolved Eligibility engine | Carolyn Dixon: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-001333 | Eligibility conflict resolved Eligibility engine | Nancy Carr: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001334 | Eligibility conflict resolved Eligibility engine | Lawrence King: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001335 | Eligibility conflict resolved Eligibility engine | Christopher Harris: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-001336 | Eligibility conflict resolved Eligibility engine | Joshua Hoffman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-001337 | Eligibility conflict resolved Eligibility engine | Camila Nelson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-001338 | Eligibility conflict resolved Eligibility engine | Brenda Lee: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-001339 | Eligibility conflict resolved Eligibility engine | Alice Silva: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-010452 | Outreach address corrected Outreach | Emma Reyes: 6614 Lake View Rd # 682, Sacramento → 6614 Lake View Rd, Sacramento |
| Proposed | — | ||
| ACT-010453 | Outreach address corrected Outreach | Billy Collins: 1834 Mountain View Dr Apt 38, Austin → 1834 Mountain View Dr, Austin |
| Proposed | — | ||
| ACT-010454 | Outreach address corrected Outreach | Patty Grant: 2725 Hillcrest Rd # 393, Mesa → 2725 Hillcrest Rd, Mesa |
| Proposed | — | ||
| ACT-010455 | Outreach address corrected Outreach | Luis Howard: 744 Harbor Blvd Apt 37, Las Vegas → 744 Harbor Blvd, Las Vegas |
| Proposed | — | ||
| ACT-010456 | Outreach address corrected Outreach | Arthur Johnson: 58 Spring St # 837, Houston → 58 Spring St, Houston |
| Proposed | — | ||
| ACT-010457 | Outreach address corrected Outreach | Roger Nelson: 9244 Mountain View Dr, Miami → 1103 Desert Sky Blvd, Tucson |
| Proposed | — | ||
| ACT-010458 | Outreach address corrected Outreach | Sara Baker: 9270 Valley View Dr Apt 7, Houston → 9270 Valley View Dr, Houston |
| Proposed | — | ||
| ACT-010459 | Outreach address corrected Outreach | Lucia Weaver: 4920 Lake View Rd Apt 18, Columbus → 4920 Lake View Rd, Columbus |
| Proposed | — | ||
| ACT-010460 | Outreach address corrected Outreach | David Rose: 703 Palm Dr, Minneapolis → 6320 Palm Dr, Scottsdale |
| Proposed | — | ||
| ACT-010461 | Outreach address corrected Outreach | Margaret Hunter: 5534 Union St # 880, Denver → 5534 Union St, Denver |
| Proposed | — | ||
| ACT-010462 | Outreach address corrected Outreach | Jordan Armstrong: 5162 Bayshore Dr, San Antonio → 5162 Bayshore Dr Apt 35, San Antonio |
| 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.