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
New member onboarding, Next-best-action, 2,081 proposed
| Action | Type | Title | Detail | Linked to | Status | Executed | |
|---|---|---|---|---|---|---|---|
| ACT-019886 | New member onboarding Next-best-action | Maria Wells: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019887 | New member onboarding Next-best-action | Scott Santos: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-019888 | New member onboarding Next-best-action | Roy Mendez: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019889 | New member onboarding Next-best-action | Hannah Crawford: enrolled 2026-09-06, no activity yet |
| Proposed | — | ||
| ACT-019890 | New member onboarding Next-best-action | Alan Wright: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019891 | New member onboarding Next-best-action | Zachary Snyder: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019892 | New member onboarding Next-best-action | Carlos Hunter: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019893 | New member onboarding Next-best-action | Bell Melissa: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-019894 | New member onboarding Next-best-action | Jaun Carroll: enrolled 2026-10-11, no activity yet |
| Proposed | — | ||
| ACT-019895 | New member onboarding Next-best-action | Sofai Phillips: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019896 | New member onboarding Next-best-action | Nicole Austin: enrolled 2026-10-15, no activity yet |
| Proposed | — | ||
| ACT-019897 | New member onboarding Next-best-action | Martha Brown: enrolled 2026-09-19, no activity yet |
| Proposed | — | ||
| ACT-019898 | New member onboarding Next-best-action | Anthony Patterson: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-019899 | New member onboarding Next-best-action | Teresa Stevens: enrolled 2026-09-22, no activity yet |
| Proposed | — | ||
| ACT-019900 | New member onboarding Next-best-action | Mason Chavez: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019901 | New member onboarding Next-best-action | Ronald Saanchez: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-019902 | New member onboarding Next-best-action | Kyle Peterson: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019903 | New member onboarding Next-best-action | Scott Carroll: enrolled 2026-09-25, no activity yet |
| Proposed | — | ||
| ACT-019904 | New member onboarding Next-best-action | Alexander Nunez: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019905 | New member onboarding Next-best-action | Logan Schultz: enrolled 2026-09-05, no activity yet |
| Proposed | — | ||
| ACT-019906 | New member onboarding Next-best-action | Doris Mejia: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-019907 | New member onboarding Next-best-action | Thomas Hudson: enrolled 2026-10-02, no activity yet |
| Proposed | — | ||
| ACT-019908 | New member onboarding Next-best-action | Brandon Ortiz: enrolled 2026-10-04, no activity yet |
| Proposed | — | ||
| ACT-019909 | New member onboarding Next-best-action | Lawrence Romero: enrolled 2026-09-14, no activity yet |
| Proposed | — | ||
| ACT-019910 | New member onboarding Next-best-action | Kimberly Fernandez: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-019911 | New member onboarding Next-best-action | Henry Adams: enrolled 2026-10-09, no activity yet |
| Proposed | — | ||
| ACT-019912 | New member onboarding Next-best-action | Donna Campbell: enrolled 2026-09-28, no activity yet |
| Proposed | — | ||
| ACT-019913 | New member onboarding Next-best-action | Judith Howard: enrolled 2026-09-07, no activity yet |
| Proposed | — | ||
| ACT-019914 | New member onboarding Next-best-action | Sarah Munoz: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-019915 | New member onboarding Next-best-action | Hiroshi Dunn: enrolled 2026-10-18, no activity yet |
| Proposed | — | ||
| ACT-019916 | New member onboarding Next-best-action | Nancy Silva: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-019917 | New member onboarding Next-best-action | Lawrence Mason: enrolled 2026-09-23, no activity yet |
| Proposed | — | ||
| ACT-019918 | New member onboarding Next-best-action | Linda Scott: enrolled 2026-10-10, no activity yet |
| Proposed | — | ||
| ACT-019919 | New member onboarding Next-best-action | Sophia Edwards: enrolled 2026-09-13, no activity yet |
| Proposed | — | ||
| ACT-019920 | New member onboarding Next-best-action | Jessica Lane: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-019921 | New member onboarding Next-best-action | Roger Bowman: enrolled 2026-09-11, no activity yet |
| Proposed | — | ||
| ACT-019922 | New member onboarding Next-best-action | Richard Lopez: enrolled 2026-09-15, no activity yet |
| Proposed | — | ||
| ACT-019923 | New member onboarding Next-best-action | Kelly Austin: enrolled 2026-10-14, no activity yet |
| Proposed | — | ||
| ACT-019924 | New member onboarding Next-best-action | Wayne Hicks: enrolled 2026-09-09, no activity yet |
| Proposed | — | ||
| ACT-019925 | New member onboarding Next-best-action | Shirley Aguilar: enrolled 2026-10-12, no activity yet |
| Proposed | — | ||
| ACT-019926 | New member onboarding Next-best-action | Ahmed Luna: enrolled 2026-09-24, no activity yet |
| Proposed | — | ||
| ACT-019927 | New member onboarding Next-best-action | Heather Ross: enrolled 2026-09-18, no activity yet |
| Proposed | — | ||
| ACT-019928 | New member onboarding Next-best-action | Christian Salazar: enrolled 2026-09-21, no activity yet |
| Proposed | — | ||
| ACT-019929 | New member onboarding Next-best-action | Nancy Arnold: enrolled 2026-10-03, no activity yet |
| Proposed | — | ||
| ACT-019930 | New member onboarding Next-best-action | Matthew Wagner: enrolled 2026-09-30, no activity yet |
| Proposed | — | ||
| ACT-019931 | New member onboarding Next-best-action | Henry King: enrolled 2026-09-17, no activity yet |
| Proposed | — | ||
| ACT-019932 | New member onboarding Next-best-action | Lori Cook: enrolled 2026-10-08, no activity yet |
| Proposed | — | ||
| ACT-019933 | New member onboarding Next-best-action | Christina Harper: enrolled 2026-09-16, no activity yet |
| Proposed | — | ||
| ACT-019934 | New member onboarding Next-best-action | Davd Dunn: enrolled 2026-09-27, no activity yet |
| Proposed | — | ||
| ACT-019935 | New member onboarding Next-best-action | Larry Smith: enrolled 2026-09-19, no activity yet |
| 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.