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-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.