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-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.