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-000151 | Eligibility conflict resolved Eligibility engine | Carlos Salazar: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000152 | Eligibility conflict resolved Eligibility engine | Dick Jimenez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000153 | Eligibility conflict resolved Eligibility engine | Kevin Guerrero: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000154 | Eligibility conflict resolved Eligibility engine | Christina Guzman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000155 | Eligibility conflict resolved Eligibility engine | Robert Ford: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000156 | Eligibility conflict resolved Eligibility engine | Emma Pena: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000157 | Eligibility conflict resolved Eligibility engine | Melissa Henderson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000158 | Eligibility conflict resolved Eligibility engine | Cynthia Vazquez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000159 | Eligibility conflict resolved Eligibility engine | Pamela Arnold: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000160 | Eligibility conflict resolved Eligibility engine | Marilyn Romero: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000161 | Eligibility conflict resolved Eligibility engine | Nicole Gonzalez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000162 | Eligibility conflict resolved Eligibility engine | Justin Le: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000163 | Eligibility conflict resolved Eligibility engine | Yuki Meyer: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000164 | Eligibility conflict resolved Eligibility engine | Arjun Elliott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000165 | Eligibility conflict resolved Eligibility engine | Mari Matthews: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000166 | Eligibility conflict resolved Eligibility engine | Juan Welch: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000167 | Eligibility conflict resolved Eligibility engine | Emily Nguyen: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000168 | Eligibility conflict resolved Eligibility engine | Ana Gordon: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000169 | Eligibility conflict resolved Eligibility engine | Bryan Black: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000170 | Eligibility conflict resolved Eligibility engine | Joan Gonzales: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000171 | Eligibility conflict resolved Eligibility engine | Judy Delgado: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000172 | Eligibility conflict resolved Eligibility engine | Brian Larson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000173 | Eligibility conflict resolved Eligibility engine | Rachel Hughes: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000174 | Eligibility conflict resolved Eligibility engine | William Moreno: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000175 | Eligibility conflict resolved Eligibility engine | Cynthia Sandoval: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000176 | Eligibility conflict resolved Eligibility engine | Jonathan Gibson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000177 | Eligibility conflict resolved Eligibility engine | Theresa West: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000178 | Eligibility conflict resolved Eligibility engine | Lawrence Welch: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000179 | Eligibility conflict resolved Eligibility engine | Doris Brooks: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000180 | Eligibility conflict resolved Eligibility engine | Jean Williamson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000181 | Eligibility conflict resolved Eligibility engine | Brian Reid: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000182 | Eligibility conflict resolved Eligibility engine | Emma Meyer: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000183 | Eligibility conflict resolved Eligibility engine | Amy Flores: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000184 | Eligibility conflict resolved Eligibility engine | Ashley Watson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000185 | Eligibility conflict resolved Eligibility engine | Shirley Adams: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000186 | Eligibility conflict resolved Eligibility engine | Jeremy Reyes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000187 | Eligibility conflict resolved Eligibility engine | Camila Murphy: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000188 | Eligibility conflict resolved Eligibility engine | Carol Gutierrez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000189 | Eligibility conflict resolved Eligibility engine | Ana Jenkins: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000190 | Eligibility conflict resolved Eligibility engine | Scott Phillips: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000191 | Eligibility conflict resolved Eligibility engine | Sean Li: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000192 | Eligibility conflict resolved Eligibility engine | Eric Walker: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000193 | Eligibility conflict resolved Eligibility engine | Betty Walsh: 3 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000194 | Eligibility conflict resolved Eligibility engine | Virginia Harper: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000195 | Eligibility conflict resolved Eligibility engine | Olivia Gilbert: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000196 | Eligibility conflict resolved Eligibility engine | Brandon Herrera: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000197 | Eligibility conflict resolved Eligibility engine | Peter Alexander: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000198 | Eligibility conflict resolved Eligibility engine | Judith Ramirez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000199 | Eligibility conflict resolved Eligibility engine | Larry Banks: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000200 | Eligibility conflict resolved Eligibility engine | Christian Anderson: 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.