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-000201 | Eligibility conflict resolved Eligibility engine | Patricck Turner: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000202 | Eligibility conflict resolved Eligibility engine | Mark Washington: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000203 | Eligibility conflict resolved Eligibility engine | Gerald Ramirez: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000204 | Eligibility conflict resolved Eligibility engine | Madison Nguyen: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000205 | Eligibility conflict resolved Eligibility engine | Albert Hughes: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000206 | Eligibility conflict resolved Eligibility engine | Paul Woods: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000207 | Eligibility conflict resolved Eligibility engine | Scott Pena: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000208 | Eligibility conflict resolved Eligibility engine | Abigail Scott: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000209 | Eligibility conflict resolved Eligibility engine | Jerry Armstrong: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000210 | Eligibility conflict resolved Eligibility engine | Anna Scott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000211 | Eligibility conflict resolved Eligibility engine | Dorothy Moreno: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000212 | Eligibility conflict resolved Eligibility engine | Pamela Hunt: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000213 | Eligibility conflict resolved Eligibility engine | Michael Boyd: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000214 | Eligibility conflict resolved Eligibility engine | Gerald Wagner: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000215 | Eligibility conflict resolved Eligibility engine | Alan Bennett: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000216 | Eligibility conflict resolved Eligibility engine | Joshua Campbell: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000217 | Eligibility conflict resolved Eligibility engine | Mariana Jackson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000218 | Eligibility conflict resolved Eligibility engine | Sarah Hunt: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000219 | Eligibility conflict resolved Eligibility engine | Albert Gonzalez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000220 | Eligibility conflict resolved Eligibility engine | Margaret Stone: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000221 | Eligibility conflict resolved Eligibility engine | Janice Patterson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000222 | Eligibility conflict resolved Eligibility engine | Madison Armstrong: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000223 | Eligibility conflict resolved Eligibility engine | Joshua Guerrero: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000224 | Eligibility conflict resolved Eligibility engine | Michael Romero: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000225 | Eligibility conflict resolved Eligibility engine | Robert Simmons: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000226 | Eligibility conflict resolved Eligibility engine | Alexis Vasquez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000227 | Eligibility conflict resolved Eligibility engine | Stephen Hayes: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000228 | Eligibility conflict resolved Eligibility engine | Brandon Lopez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000229 | Eligibility conflict resolved Eligibility engine | Grace Hernandez: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000230 | Eligibility conflict resolved Eligibility engine | Emma Mitchell: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000231 | Eligibility conflict resolved Eligibility engine | Albert Wallace: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000232 | Eligibility conflict resolved Eligibility engine | Jacqueline Gomez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000233 | Eligibility conflict resolved Eligibility engine | Julie Lee: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000234 | Eligibility conflict resolved Eligibility engine | Zachary Green: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000235 | Eligibility conflict resolved Eligibility engine | Stephen Hoffman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000236 | Eligibility conflict resolved Eligibility engine | Stephanie Ramirez: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000237 | Eligibility conflict resolved Eligibility engine | Martha Marshall: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000238 | Eligibility conflict resolved Eligibility engine | Vincent Sullivan: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000239 | Eligibility conflict resolved Eligibility engine | Becky Espinoza: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000240 | Eligibility conflict resolved Eligibility engine | Jean Carr: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000241 | Eligibility conflict resolved Eligibility engine | Raymond Banks: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000242 | Eligibility conflict resolved Eligibility engine | Stephanie Day: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000243 | Eligibility conflict resolved Eligibility engine | Logan Santos: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000244 | Eligibility conflict resolved Eligibility engine | Mariana Nguyen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000245 | Eligibility conflict resolved Eligibility engine | Ann Lopez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000246 | Eligibility conflict resolved Eligibility engine | Kenneth Cooper: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000247 | Eligibility conflict resolved Eligibility engine | Douglas Stewart: 3 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000248 | Eligibility conflict resolved Eligibility engine | Emma Ramirez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000249 | Eligibility conflict resolved Eligibility engine | David Andrews: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000250 | Eligibility conflict resolved Eligibility engine | Anthony Carr: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| 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.