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-000301 | Eligibility conflict resolved Eligibility engine | Laura Gonzales: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000302 | Eligibility conflict resolved Eligibility engine | Angela Greene: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000303 | Eligibility conflict resolved Eligibility engine | Randy Fisher: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000304 | Eligibility conflict resolved Eligibility engine | Philip Maldonado: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000305 | Eligibility conflict resolved Eligibility engine | Douglas James: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000306 | Eligibility conflict resolved Eligibility engine | George Lawson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000307 | Eligibility conflict resolved Eligibility engine | Roy Ellis: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000308 | Eligibility conflict resolved Eligibility engine | Katherine Carpenter: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000309 | Eligibility conflict resolved Eligibility engine | Sophia Jacobs: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000310 | Eligibility conflict resolved Eligibility engine | Henry Watson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000311 | Eligibility conflict resolved Eligibility engine | Diana Dean: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000312 | Eligibility conflict resolved Eligibility engine | Ashley Bowman: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000313 | Eligibility conflict resolved Eligibility engine | Jonathan Bowman: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000314 | Eligibility conflict resolved Eligibility engine | George Mejia: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000315 | Eligibility conflict resolved Eligibility engine | Janet Young: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000316 | Eligibility conflict resolved Eligibility engine | Julia Adams: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000317 | Eligibility conflict resolved Eligibility engine | Judy Franklin: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000318 | Eligibility conflict resolved Eligibility engine | Lawrence Jackson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000319 | Eligibility conflict resolved Eligibility engine | Aisha Hughes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000320 | Eligibility conflict resolved Eligibility engine | Bruce Henry: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000321 | Eligibility conflict resolved Eligibility engine | Philip Scott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000322 | Eligibility conflict resolved Eligibility engine | Rebecca Sims: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000323 | Eligibility conflict resolved Eligibility engine | Kyle Weber: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000324 | Eligibility conflict resolved Eligibility engine | Gloria Ray: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000325 | Eligibility conflict resolved Eligibility engine | Timothy Hill: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000326 | Eligibility conflict resolved Eligibility engine | Isabella Gordon: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000327 | Eligibility conflict resolved Eligibility engine | Ahmed Singh: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000328 | Eligibility conflict resolved Eligibility engine | Aaron Pierce: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000329 | Eligibility conflict resolved Eligibility engine | Martha Watson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000330 | Eligibility conflict resolved Eligibility engine | Frances Williamson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000331 | Eligibility conflict resolved Eligibility engine | Martha Henderson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000332 | Eligibility conflict resolved Eligibility engine | Ruth Hudson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000333 | Eligibility conflict resolved Eligibility engine | Sandra Reed: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000334 | Eligibility conflict resolved Eligibility engine | Santiago Hoffman: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000335 | Eligibility conflict resolved Eligibility engine | Stephen Fowler: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000336 | Eligibility conflict resolved Eligibility engine | Ralph Santos: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000337 | Eligibility conflict resolved Eligibility engine | Priya McDonald: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000338 | Eligibility conflict resolved Eligibility engine | David Garcia: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000339 | Eligibility conflict resolved Eligibility engine | Kathleen Jacobs: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000340 | Eligibility conflict resolved Eligibility engine | Linda Paye: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000341 | Eligibility conflict resolved Eligibility engine | Vincent Gordon: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000342 | Eligibility conflict resolved Eligibility engine | Donna Stephens: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000343 | Eligibility conflict resolved Eligibility engine | Gerald Hansen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000344 | Eligibility conflict resolved Eligibility engine | Henry Dean: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000345 | Eligibility conflict resolved Eligibility engine | Marcus Myers: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000346 | Eligibility conflict resolved Eligibility engine | Jose Williamson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000347 | Eligibility conflict resolved Eligibility engine | Austin Allen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000348 | Eligibility conflict resolved Eligibility engine | Betty Peters: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000349 | Eligibility conflict resolved Eligibility engine | Theresa Cruz: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000350 | Eligibility conflict resolved Eligibility engine | Walter Little: 2 plan codes across sources → canonical OPTIONS-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.