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-000351 | Eligibility conflict resolved Eligibility engine | Lauren Kelly: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000352 | Eligibility conflict resolved Eligibility engine | Abigail George: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000353 | Eligibility conflict resolved Eligibility engine | Jonathan Burke: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000354 | Eligibility conflict resolved Eligibility engine | Christine Gonzales: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000355 | Eligibility conflict resolved Eligibility engine | Willie Elliott: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000356 | Eligibility conflict resolved Eligibility engine | Rachel Wagner: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000357 | Eligibility conflict resolved Eligibility engine | Robert Brooks: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000358 | Eligibility conflict resolved Eligibility engine | Brenda Butler: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000359 | Eligibility conflict resolved Eligibility engine | Carol Willis: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000360 | Eligibility conflict resolved Eligibility engine | Lori Porter: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000361 | Eligibility conflict resolved Eligibility engine | Deborah Sullivan: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000362 | Eligibility conflict resolved Eligibility engine | Raymond Banks: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000363 | Eligibility conflict resolved Eligibility engine | Katherine Lucas: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000364 | Eligibility conflict resolved Eligibility engine | Philip Wright: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000365 | Eligibility conflict resolved Eligibility engine | Lawrence Nichols: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000366 | Eligibility conflict resolved Eligibility engine | Mark Harvey: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000367 | Eligibility conflict resolved Eligibility engine | Alexander Robertson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000368 | Eligibility conflict resolved Eligibility engine | Austin Matthews: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000369 | Eligibility conflict resolved Eligibility engine | John Maldonado: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000370 | Eligibility conflict resolved Eligibility engine | Debra Hoffman: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000371 | Eligibility conflict resolved Eligibility engine | Isabella Fisher: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000372 | Eligibility conflict resolved Eligibility engine | Arthur Holmes: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000373 | Eligibility conflict resolved Eligibility engine | Stephanie Ward: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000374 | Eligibility conflict resolved Eligibility engine | Adam Walsh: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000375 | Eligibility conflict resolved Eligibility engine | Betty Allen: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000376 | Eligibility conflict resolved Eligibility engine | Benjamin Payne: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000377 | Eligibility conflict resolved Eligibility engine | Ethan Reyse: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000378 | Eligibility conflict resolved Eligibility engine | Kyle Watkins: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000379 | Eligibility conflict resolved Eligibility engine | Megan Kim: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000380 | Eligibility conflict resolved Eligibility engine | Alan Soto: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000381 | Eligibility conflict resolved Eligibility engine | Kathleen Sandoval: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000382 | Eligibility conflict resolved Eligibility engine | Nicole Daniels: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000383 | Eligibility conflict resolved Eligibility engine | Andrew Dean: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000384 | Eligibility conflict resolved Eligibility engine | Mason Gardner: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000385 | Eligibility conflict resolved Eligibility engine | Melissa Soto: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000386 | Eligibility conflict resolved Eligibility engine | Camila Morgan: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000387 | Eligibility conflict resolved Eligibility engine | Wei Robinson: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000388 | Eligibility conflict resolved Eligibility engine | Ana Allen: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000389 | Eligibility conflict resolved Eligibility engine | Beverly Elliott: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000390 | Eligibility conflict resolved Eligibility engine | Jennifer Medina: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000391 | Eligibility conflict resolved Eligibility engine | Christine Davis: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000392 | Eligibility conflict resolved Eligibility engine | Margaret Taylor: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000393 | Eligibility conflict resolved Eligibility engine | Samantha West: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000394 | Eligibility conflict resolved Eligibility engine | Lauren Perry: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000395 | Eligibility conflict resolved Eligibility engine | Keith Jimenez: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000396 | Eligibility conflict resolved Eligibility engine | Valentina Nguyen: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000397 | Eligibility conflict resolved Eligibility engine | John Ferguson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000398 | Eligibility conflict resolved Eligibility engine | Steven Watkins: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000399 | Eligibility conflict resolved Eligibility engine | Hiroshi Lewis: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000400 | Eligibility conflict resolved Eligibility engine | Sharon Diaz: 2 plan codes across sources → canonical CHOICE-PLUS-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.