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-000101 | Eligibility conflict resolved Eligibility engine | Frank Lawrence: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000102 | Eligibility conflict resolved Eligibility engine | Larry Perez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000103 | Eligibility conflict resolved Eligibility engine | George Austin: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000104 | Eligibility conflict resolved Eligibility engine | Diane Carter: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000105 | Eligibility conflict resolved Eligibility engine | Jeffrey Cox: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000106 | Eligibility conflict resolved Eligibility engine | Nicholas Coleman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000107 | Eligibility conflict resolved Eligibility engine | Ryan Rogers: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000108 | Eligibility conflict resolved Eligibility engine | Heather Fuller: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000109 | Eligibility conflict resolved Eligibility engine | James Long: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000110 | Eligibility conflict resolved Eligibility engine | Billy Barnes: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000111 | Eligibility conflict resolved Eligibility engine | Christian Marshall: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000112 | Eligibility conflict resolved Eligibility engine | Denise Roberts: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000113 | Eligibility conflict resolved Eligibility engine | Russell Gordon: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000114 | Eligibility conflict resolved Eligibility engine | Joyce Carter: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000115 | Eligibility conflict resolved Eligibility engine | Henry Lane: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000116 | Eligibility conflict resolved Eligibility engine | Zachary Maldonado: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000117 | Eligibility conflict resolved Eligibility engine | Barbara Park: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000118 | Eligibility conflict resolved Eligibility engine | Jeffrey Martin: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000119 | Eligibility conflict resolved Eligibility engine | Jonathan Rivera: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000120 | Eligibility conflict resolved Eligibility engine | Diego Montgomery: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000121 | Eligibility conflict resolved Eligibility engine | Chris Meyer: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000122 | Eligibility conflict resolved Eligibility engine | Hannah Simpson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000123 | Eligibility conflict resolved Eligibility engine | Jack Hall: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000124 | Eligibility conflict resolved Eligibility engine | Bryan Jenkins: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000125 | Eligibility conflict resolved Eligibility engine | Yuki Richardson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000126 | Eligibility conflict resolved Eligibility engine | Jacqueline Evans: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000127 | Eligibility conflict resolved Eligibility engine | Evelyn Coleman: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000128 | Eligibility conflict resolved Eligibility engine | Doris Guzman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000129 | Eligibility conflict resolved Eligibility engine | Scott Thomas: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000130 | Eligibility conflict resolved Eligibility engine | Karen Fowler: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000131 | Eligibility conflict resolved Eligibility engine | Mark Crawford: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000132 | Eligibility conflict resolved Eligibility engine | Jacqueline Chen: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000133 | Eligibility conflict resolved Eligibility engine | Tyler Snyder: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000134 | Eligibility conflict resolved Eligibility engine | Yuki Maldonado: 3 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000135 | Eligibility conflict resolved Eligibility engine | Keith Lopez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000136 | Eligibility conflict resolved Eligibility engine | Diego Guerrero: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000137 | Eligibility conflict resolved Eligibility engine | Patrick Jenkins: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000138 | Eligibility conflict resolved Eligibility engine | Michelle Carpenter: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000139 | Eligibility conflict resolved Eligibility engine | Margaret Roberts: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000140 | Eligibility conflict resolved Eligibility engine | Olivia Fox: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000141 | Eligibility conflict resolved Eligibility engine | Peter Tucker: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000142 | Eligibility conflict resolved Eligibility engine | Patricia Flores: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000143 | Eligibility conflict resolved Eligibility engine | Cynthia Ortega: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000144 | Eligibility conflict resolved Eligibility engine | Billy Henderson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000145 | Eligibility conflict resolved Eligibility engine | Alice Baker: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000146 | Eligibility conflict resolved Eligibility engine | Laura Obrien: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000147 | Eligibility conflict resolved Eligibility engine | Olivia Padilla: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000148 | Eligibility conflict resolved Eligibility engine | Ana Ortega: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000149 | Eligibility conflict resolved Eligibility engine | Heather Walsh: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000150 | Eligibility conflict resolved Eligibility engine | Sandra Obrien: 2 plan codes across sources → canonical NAVIGATE-HMO |
| 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.