Action	Type	Title	Detail	Linked to	Status	Executed
ACT-019571	Care coordination outreach Next-best-action	Shaaron Burns: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-039267	Proposed	—
ACT-019572	Care coordination outreach Next-best-action	Sareh Carter: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-039295	Proposed	—
ACT-019573	Care coordination outreach Next-best-action	Daniel Rios: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-039306	Proposed	—
ACT-019574	Care coordination outreach Next-best-action	Abigail Phillips: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-039513	Proposed	—
ACT-019575	Care coordination outreach Next-best-action	Lauren Lynch: 4 claims, no attributed provider	Claims 4 Recommendation assign PCP and schedule care-coordination call	MBR-039674	Proposed	—
ACT-019576	Care coordination outreach Next-best-action	Beverly Hughes: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-039856	Proposed	—
ACT-019577	Care coordination outreach Next-best-action	Nancy Tran: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-040559	Proposed	—
ACT-019578	Care coordination outreach Next-best-action	Karen Wells: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-040650	Proposed	—
ACT-019579	Care coordination outreach Next-best-action	Alice Hart: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-041383	Proposed	—
ACT-019580	Care coordination outreach Next-best-action	Gary Espinoza: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-041505	Proposed	—
ACT-019581	Care coordination outreach Next-best-action	Susan Scott: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-041635	Proposed	—
ACT-019582	Care coordination outreach Next-best-action	Jacqueline Willis: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-041961	Proposed	—
ACT-019583	Care coordination outreach Next-best-action	Kenneth Morgan: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-042473	Proposed	—
ACT-019584	Care coordination outreach Next-best-action	Christina Burke: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-042746	Proposed	—
ACT-019585	Care coordination outreach Next-best-action	Rebecca Sandoval: 3 claims, no attributed provider	Claims 3 Recommendation assign PCP and schedule care-coordination call	MBR-043849	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.