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-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.