Action	Type	Title	Detail	Linked to	Status	Executed
ACT-019121	Care coordination outreach Next-best-action	Roy Watson: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-020720	Proposed	—
ACT-019122	Care coordination outreach Next-best-action	Brenda Nelson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020771	Proposed	—
ACT-019123	Care coordination outreach Next-best-action	Dylan Stewart: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020815	Proposed	—
ACT-019124	Care coordination outreach Next-best-action	Roger Powell: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020831	Proposed	—
ACT-019125	Care coordination outreach Next-best-action	Sofia Arnold: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020867	Proposed	—
ACT-019126	Care coordination outreach Next-best-action	Emily Silva: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-020896	Proposed	—
ACT-019127	Care coordination outreach Next-best-action	Anthony Elliott: 5 claims, no attributed provider	Claims 5 Recommendation assign PCP and schedule care-coordination call	MBR-020909	Proposed	—
ACT-019128	Care coordination outreach Next-best-action	Heather Soto: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020945	Proposed	—
ACT-019129	Care coordination outreach Next-best-action	Dylan Gomez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020947	Proposed	—
ACT-019130	Care coordination outreach Next-best-action	Ana Gilbert: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-020948	Proposed	—
ACT-019131	Care coordination outreach Next-best-action	Alice Duncan: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-020958	Proposed	—
ACT-019132	Care coordination outreach Next-best-action	Julie Evans: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020970	Proposed	—
ACT-019133	Care coordination outreach Next-best-action	Andrea King: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020984	Proposed	—
ACT-019134	Care coordination outreach Next-best-action	Ana Robinson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-020998	Proposed	—
ACT-019135	Care coordination outreach Next-best-action	Sophia Martinez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021022	Proposed	—
ACT-019136	Care coordination outreach Next-best-action	Sara Wagner: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021052	Proposed	—
ACT-019137	Care coordination outreach Next-best-action	Bobby Miller: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021075	Proposed	—
ACT-019138	Care coordination outreach Next-best-action	Cheryl Bishop: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021131	Proposed	—
ACT-019139	Care coordination outreach Next-best-action	Ronald Padilla: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021175	Proposed	—
ACT-019140	Care coordination outreach Next-best-action	Rebecca Robinson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021205	Proposed	—
ACT-019141	Care coordination outreach Next-best-action	Timothy Howell: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021210	Proposed	—
ACT-019142	Care coordination outreach Next-best-action	Eugene Soto: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021235	Proposed	—
ACT-019143	Care coordination outreach Next-best-action	Jacob Vasquez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021300	Proposed	—
ACT-019144	Care coordination outreach Next-best-action	Susan Perez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021307	Proposed	—
ACT-019145	Care coordination outreach Next-best-action	Albert Marquez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021350	Proposed	—
ACT-019146	Care coordination outreach Next-best-action	Victoria Weber: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021358	Proposed	—
ACT-019147	Care coordination outreach Next-best-action	Isabella Dominguez: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021374	Proposed	—
ACT-019148	Care coordination outreach Next-best-action	Dennis Ray: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021384	Proposed	—
ACT-019149	Care coordination outreach Next-best-action	Walter Black: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021423	Proposed	—
ACT-019150	Care coordination outreach Next-best-action	Maria Myers: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021440	Proposed	—
ACT-019151	Care coordination outreach Next-best-action	Kathryn Day: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021464	Proposed	—
ACT-019152	Care coordination outreach Next-best-action	Aisha Rojas: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021466	Proposed	—
ACT-019153	Care coordination outreach Next-best-action	Gloria Le: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021473	Proposed	—
ACT-019154	Care coordination outreach Next-best-action	Fatima Espinoza: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021476	Proposed	—
ACT-019155	Care coordination outreach Next-best-action	Emma Sanders: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021491	Proposed	—
ACT-019156	Care coordination outreach Next-best-action	Bobby Stephens: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021500	Proposed	—
ACT-019157	Care coordination outreach Next-best-action	Judy Rivera: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021595	Proposed	—
ACT-019158	Care coordination outreach Next-best-action	Rebecca Jacobs: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021607	Proposed	—
ACT-019159	Care coordination outreach Next-best-action	Marilyn Meyer: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021650	Proposed	—
ACT-019160	Care coordination outreach Next-best-action	Dennis Dunn: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021682	Proposed	—
ACT-019161	Care coordination outreach Next-best-action	Diana Stephens: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021695	Proposed	—
ACT-019162	Care coordination outreach Next-best-action	Teresa Bishop: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021715	Proposed	—
ACT-019163	Care coordination outreach Next-best-action	Grace Ross: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021800	Proposed	—
ACT-019164	Care coordination outreach Next-best-action	Jack Garza: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021847	Proposed	—
ACT-019165	Care coordination outreach Next-best-action	Shirley Hunter: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021914	Proposed	—
ACT-019166	Care coordination outreach Next-best-action	Benjamin Hunt: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-021931	Proposed	—
ACT-019167	Care coordination outreach Next-best-action	Ethan Williamson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-021932	Proposed	—
ACT-019168	Care coordination outreach Next-best-action	Joseph Scott: 5 claims, no attributed provider	Claims 5 Recommendation assign PCP and schedule care-coordination call	MBR-021986	Proposed	—
ACT-019169	Care coordination outreach Next-best-action	Pamela Lucas: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-022043	Proposed	—
ACT-019170	Care coordination outreach Next-best-action	Gregory Kelley: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-022047	Proposed	—

1,815 rows, page 28 of 37Previous Next

Derivation rules

Evaluated after every gold rebuild

1
Eligibility conflict resolved
The records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
2
Orphan claim re-pointed
A 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.
3
Outreach address corrected
The most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
4
Outreach suppressed pending steward
The record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
5
Care coordination outreach
Three or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
6
New member onboarding
A single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
7
Duplicate member record retired
Two or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.