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-000251 | Eligibility conflict resolved Eligibility engine | Rachel Lopez: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000252 | Eligibility conflict resolved Eligibility engine | Ralph Knight: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000253 | Eligibility conflict resolved Eligibility engine | Jose Bryant: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000254 | Eligibility conflict resolved Eligibility engine | Sean Price: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000255 | Eligibility conflict resolved Eligibility engine | Ahmed Riley: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000256 | Eligibility conflict resolved Eligibility engine | Diego Greene: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000257 | Eligibility conflict resolved Eligibility engine | Christine Dixon: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000258 | Eligibility conflict resolved Eligibility engine | Randy Flores: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000259 | Eligibility conflict resolved Eligibility engine | Arjun Hanson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000260 | Eligibility conflict resolved Eligibility engine | Eric Schmidt: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000261 | Eligibility conflict resolved Eligibility engine | Ann Reed: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000262 | Eligibility conflict resolved Eligibility engine | David Yang: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000263 | Eligibility conflict resolved Eligibility engine | Natalie Bennett: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000264 | Eligibility conflict resolved Eligibility engine | Catherine Gordon: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000265 | Eligibility conflict resolved Eligibility engine | Yuki Burton: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000266 | Eligibility conflict resolved Eligibility engine | Madison Daniels: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000267 | Eligibility conflict resolved Eligibility engine | Andrew Lawson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000268 | Eligibility conflict resolved Eligibility engine | Benjamin Cox: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000269 | Eligibility conflict resolved Eligibility engine | Frances Pena: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000270 | Eligibility conflict resolved Eligibility engine | Ahmed Peters: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000271 | Eligibility conflict resolved Eligibility engine | Christina Lynch: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000272 | Eligibility conflict resolved Eligibility engine | Nicholas Alexander: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000273 | Eligibility conflict resolved Eligibility engine | Bobby Wright: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000274 | Eligibility conflict resolved Eligibility engine | Patricia Hamilton: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000275 | Eligibility conflict resolved Eligibility engine | Jeremy Hunter: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000276 | Eligibility conflict resolved Eligibility engine | John Salazar: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000277 | Eligibility conflict resolved Eligibility engine | Anthony Riley: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000278 | Eligibility conflict resolved Eligibility engine | Jerry Obrien: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000279 | Eligibility conflict resolved Eligibility engine | William Hansen: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000280 | Eligibility conflict resolved Eligibility engine | Nicholas West: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000281 | Eligibility conflict resolved Eligibility engine | Brenda Weaver: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000282 | Eligibility conflict resolved Eligibility engine | Harold Rivera: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000283 | Eligibility conflict resolved Eligibility engine | Charles Lewis: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000284 | Eligibility conflict resolved Eligibility engine | Christine Graham: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000285 | Eligibility conflict resolved Eligibility engine | Jacqueline James: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000286 | Eligibility conflict resolved Eligibility engine | Gerald Rios: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000287 | Eligibility conflict resolved Eligibility engine | Jacob Rojas: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000288 | Eligibility conflict resolved Eligibility engine | Gabriel Roberts: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000289 | Eligibility conflict resolved Eligibility engine | Benjamin Gibson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000290 | Eligibility conflict resolved Eligibility engine | Andrew Barnes: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000291 | Eligibility conflict resolved Eligibility engine | Stephen Scott: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000292 | Eligibility conflict resolved Eligibility engine | Charlotte Bryant: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000293 | Eligibility conflict resolved Eligibility engine | Mateo Taylor: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000294 | Eligibility conflict resolved Eligibility engine | Douglas Kim: 3 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000295 | Eligibility conflict resolved Eligibility engine | Priya Spencer: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000296 | Eligibility conflict resolved Eligibility engine | Doris Robertson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000297 | Eligibility conflict resolved Eligibility engine | Pamela Yang: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000298 | Eligibility conflict resolved Eligibility engine | Brandon Sandoval: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000299 | Eligibility conflict resolved Eligibility engine | Jonathan Davis: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000300 | Eligibility conflict resolved Eligibility engine | Donna Silva: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| 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.