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
Eligibility conflict resolved, Eligibility engine, 1,339 proposed
| 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.