Action	Type	Title	Detail	Linked to	Status	Executed
ACT-019421	Care coordination outreach Next-best-action	Mark Edwards: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-028841	Proposed	—
ACT-019422	Care coordination outreach Next-best-action	Kathryn Payne: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028845	Proposed	—
ACT-019423	Care coordination outreach Next-best-action	Frances Ruiz: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-028973	Proposed	—
ACT-019424	Care coordination outreach Next-best-action	Priya Henry: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029030	Proposed	—
ACT-019425	Care coordination outreach Next-best-action	Heather Willis: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029110	Proposed	—
ACT-019426	Care coordination outreach Next-best-action	Jason Perez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029134	Proposed	—
ACT-019427	Care coordination outreach Next-best-action	Denise Stephens: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029228	Proposed	—
ACT-019428	Care coordination outreach Next-best-action	Bobby Santos: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029462	Proposed	—
ACT-019429	Care coordination outreach Next-best-action	Brandon Vazquez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029477	Proposed	—
ACT-019430	Care coordination outreach Next-best-action	Charlotte Coleman: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029619	Proposed	—
ACT-019431	Care coordination outreach Next-best-action	Anna Clark: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029649	Proposed	—
ACT-019432	Care coordination outreach Next-best-action	Mary Wilson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029755	Proposed	—
ACT-019433	Care coordination outreach Next-best-action	Frank Guzman: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029781	Proposed	—
ACT-019434	Care coordination outreach Next-best-action	Sean Howell: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029859	Proposed	—
ACT-019435	Care coordination outreach Next-best-action	Nicole Sullivan: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029876	Proposed	—
ACT-019436	Care coordination outreach Next-best-action	Sandra Simmons: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029877	Proposed	—
ACT-019437	Care coordination outreach Next-best-action	Elizabeth Tucker: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029921	Proposed	—
ACT-019438	Care coordination outreach Next-best-action	Edward Dunn: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029930	Proposed	—
ACT-019439	Care coordination outreach Next-best-action	Michelle Medina: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029951	Proposed	—
ACT-019440	Care coordination outreach Next-best-action	Ashley Garza: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029965	Proposed	—
ACT-019441	Care coordination outreach Next-best-action	Carlos Austin: 5 claims, no attributed provider	Claims 5 Recommendation assign PCP and schedule care-coordination call	MBR-029976	Proposed	—
ACT-019442	Care coordination outreach Next-best-action	Hiroshi Martinez: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-029992	Proposed	—
ACT-019443	Care coordination outreach Next-best-action	Deborah Freeman: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-029997	Proposed	—
ACT-019444	Care coordination outreach Next-best-action	Tyler Gray: 5 claims, no attributed provider	Claims 5 Recommendation assign PCP and schedule care-coordination call	MBR-030062	Proposed	—
ACT-019445	Care coordination outreach Next-best-action	Ronald Richardson: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-030114	Proposed	—
ACT-019446	Care coordination outreach Next-best-action	Bradley Robinson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030116	Proposed	—
ACT-019447	Care coordination outreach Next-best-action	Cynthia Contreras: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030178	Proposed	—
ACT-019448	Care coordination outreach Next-best-action	Noah James: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030355	Proposed	—
ACT-019449	Care coordination outreach Next-best-action	Heather Williamson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030508	Proposed	—
ACT-019450	Care coordination outreach Next-best-action	Gregory Mendez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030510	Proposed	—
ACT-019451	Care coordination outreach Next-best-action	Kayla Knight: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030527	Proposed	—
ACT-019452	Care coordination outreach Next-best-action	Alice Mejia: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-030620	Proposed	—
ACT-019453	Care coordination outreach Next-best-action	Juhn Sullivan: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030628	Proposed	—
ACT-019454	Care coordination outreach Next-best-action	Bobby Mason: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-030688	Proposed	—
ACT-019455	Care coordination outreach Next-best-action	Vicky Lynch: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030704	Proposed	—
ACT-019456	Care coordination outreach Next-best-action	Brittany Nunez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030833	Proposed	—
ACT-019457	Care coordination outreach Next-best-action	Mary Weber: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030895	Proposed	—
ACT-019458	Care coordination outreach Next-best-action	Christian Nguyen: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-030897	Proposed	—
ACT-019459	Care coordination outreach Next-best-action	Sharon Guzman: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030935	Proposed	—
ACT-019460	Care coordination outreach Next-best-action	Willie Cole: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030960	Proposed	—
ACT-019461	Care coordination outreach Next-best-action	Kevin Powell: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-030990	Proposed	—
ACT-019462	Care coordination outreach Next-best-action	Ana Jackson: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031010	Proposed	—
ACT-019463	Care coordination outreach Next-best-action	Olivia Hughes: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031026	Proposed	—
ACT-019464	Care coordination outreach Next-best-action	Ralph Pena: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031031	Proposed	—
ACT-019465	Care coordination outreach Next-best-action	Steven Griffin: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031107	Proposed	—
ACT-019466	Care coordination outreach Next-best-action	Christine Harvey: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031129	Proposed	—
ACT-019467	Care coordination outreach Next-best-action	Michael Evans: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031146	Proposed	—
ACT-019468	Care coordination outreach Next-best-action	Luis Smith: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031168	Proposed	—
ACT-019469	Care coordination outreach Next-best-action	Kathryn Lawson: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-031304	Proposed	—
ACT-019470	Care coordination outreach Next-best-action	Lauren Gutierrez: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-031367	Proposed	—

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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.