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-013413 | Outreach address corrected Outreach | Charles Ford: 8772 Maple Ave Apt 18, Tucson → 8772 Maple Ave, Tucson |
| Proposed | — | ||
| ACT-013414 | Outreach address corrected Outreach | Sean Payne: 7739 Mesa Dr, Austin → 7324 Maple Ave, Columbus |
| Proposed | — | ||
| ACT-013415 | Outreach address corrected Outreach | Julia McCoy: 5228 Park Pl, Plano → 3123 Willow Ct, San Antonio |
| Proposed | — | ||
| ACT-013416 | Outreach address corrected Outreach | Omar Sanchez: 1184 Pine Dr, Austin → 1184 Pine Dr # 247, Austin |
| Proposed | — | ||
| ACT-013417 | Outreach address corrected Outreach | Aaron Torrees: 6393 Mountain View Dr Apt 3, Minneapolis → 6393 Mountain View Dr, Minneapolis |
| Proposed | — | ||
| ACT-013418 | Outreach address corrected Outreach | Ana Rojas: 2168 Meadow Ln Apt 31, Mesa → 2168 Meadow Ln, Mesa |
| Proposed | — | ||
| ACT-013419 | Outreach address corrected Outreach | Noah Ryan: 2398 Willow Ct, San Antonio → 2398 Willow Ct Apt 38, San Antonio |
| Proposed | — | ||
| ACT-013420 | Outreach address corrected Outreach | Rebecca Wheeler: 627 Apache Blvd, Nashville → 1319 Elm St, Sacramento |
| Proposed | — | ||
| ACT-013421 | Outreach address corrected Outreach | Diana McDonald: 3084 Elm St, Plano → 5119 Canyon Rd, Nashville |
| Proposed | — | ||
| ACT-013422 | Outreach address corrected Outreach | Melissa Raed: 3282 Church St, Los Angeles → 3282 Church St # 660, Los Angeles |
| Proposed | — | ||
| ACT-013423 | Outreach address corrected Outreach | Ashley Fernandez: 6961 Lake View Rd Apt 31, Fresno → 6961 Lake View Rd, Fresno |
| Proposed | — | ||
| ACT-013424 | Outreach address corrected Outreach | Ashley Synder: 3146 Sage Ct, Nashville → 3146 Sage Ct # 677, Nashville |
| Proposed | — | ||
| ACT-013425 | Outreach address corrected Outreach | Bobby Hart: 6693 Meadow Ln, Miami → 9401 Camelback Rd, Las Vegas |
| Proposed | — | ||
| ACT-013426 | Outreach address corrected Outreach | Mariana Matthews: 241 Jefferson Ave, Tempe → 241 Jefferson Ave # 948, Tempe |
| Proposed | — | ||
| ACT-013427 | Outreach address corrected Outreach | Judith Valdez: 6196 Baseline Rd Apt 16, San Diego → 6196 Baseline Rd, San Diego |
| Proposed | — | ||
| ACT-013428 | Outreach address corrected Outreach | Mei Thompson: 3545 Harbor Blvd # 572, San Antonio → 3545 Harbor Blvd, San Antonio |
| Proposed | — | ||
| ACT-013429 | Outreach address corrected Outreach | Laura Rogers: 2821 River Rd Apt 20, Tempe → 2821 River Rd, Tempe |
| Proposed | — | ||
| ACT-013430 | Outreach address corrected Outreach | Camila Nelson: 5213 Valley View Dr, San Antonio → 1110 Sunset Blvd, Fresno |
| Proposed | — | ||
| ACT-013431 | Outreach address corrected Outreach | Burns Alice: 1416 Pine Dr # 154, Scottsdale → 1416 Pine Dr, Scottsdale |
| Proposed | — | ||
| ACT-013432 | Outreach address corrected Outreach | Joey Smiht: 3961 Ridge Rd, Phoenix → 3961 Ridge Rd Apt 11, Phoenix |
| Proposed | — | ||
| ACT-013433 | Outreach address corrected Outreach | Juan Wells: 8015 Lake View Rd, Orlando → 943 Lincoln Way, Dallas |
| Proposed | — | ||
| ACT-013434 | Outreach address corrected Outreach | Aaron Pierce: 9338 Spring St, Columbus → 9338 Spring St # 712, Columbus |
| Proposed | — | ||
| ACT-013435 | Outreach address corrected Outreach | Denise Spencer: 7119 Canyon Rd, Jacksonville → 8865 Bayshore Dr, Los Angeles |
| Proposed | — | ||
| ACT-013436 | Outreach address corrected Outreach | Christina Ramos: 7157 Market St, Los Angeles → 7083 Grand Ave, Seattle |
| Proposed | — | ||
| ACT-013437 | Outreach address corrected Outreach | Angela Lopez: 7803 Canyon Rd Apt 39, Houston → 7803 Canyon Rd, Houston |
| Proposed | — | ||
| ACT-013438 | Outreach address corrected Outreach | Scott Vazquez: 7201 Sunset Blvd Apt 12, Charlotte → 7201 Sunset Blvd, Charlotte |
| Proposed | — | ||
| ACT-013439 | Outreach address corrected Outreach | Emily Adams: 9365 Sage Ct # 739, Orlando → 9365 Sage Ct, Orlando |
| Proposed | — | ||
| ACT-013440 | Outreach address corrected Outreach | Andrew Reyes: 6345 Ridge Rd, Eden Prairie → 6345 Ridge Rd Apt 29, Eden Prairie |
| Proposed | — | ||
| ACT-013441 | Outreach address corrected Outreach | Nathan Day: 4425 Broadway, Dallas → 4425 Broadway Apt 22, Dallas |
| Proposed | — | ||
| ACT-013442 | Outreach address corrected Outreach | Juan Tran: 354 Central Ave # 791, Plano → 354 Central Ave Apt 33, Plano |
| Proposed | — | ||
| ACT-013443 | Outreach address corrected Outreach | Eric Bowman: 8419 Central Ave # 287, Nashville → 2259 River Rd, Minneapolis |
| Proposed | — | ||
| ACT-013444 | Outreach address corrected Outreach | Henry Rios: 2185 Palm Dr, San Antonio → 2185 Palm Dr Apt 24, San Antonio |
| Proposed | — | ||
| ACT-017771 | Care coordination outreach Next-best-action | Willie Martin: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017772 | Care coordination outreach Next-best-action | Kimberly Marquez: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017773 | Care coordination outreach Next-best-action | Michelle Carr: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017774 | Care coordination outreach Next-best-action | Jack Yang: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017775 | Care coordination outreach Next-best-action | Gerald Marquez: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017776 | Care coordination outreach Next-best-action | Richard Santiago: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-017777 | Care coordination outreach Next-best-action | Kyle Kennedy: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017778 | Care coordination outreach Next-best-action | Diego West: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-017779 | Care coordination outreach Next-best-action | Lauren Wang: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-017780 | Care coordination outreach Next-best-action | Kyle Phillips: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017781 | Care coordination outreach Next-best-action | Robert Robinson: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017782 | Care coordination outreach Next-best-action | Wayne Marshall: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017783 | Care coordination outreach Next-best-action | Barbara Ruiz: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017784 | Care coordination outreach Next-best-action | Gary Knight: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017785 | Care coordination outreach Next-best-action | Pamela Matthews: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-017786 | Care coordination outreach Next-best-action | Albert Jacobs: 3 claims, no attributed provider |
| Proposed | — | ||
| ACT-017787 | Care coordination outreach Next-best-action | Raymond Walsh: 4 claims, no attributed provider |
| Proposed | — | ||
| ACT-017788 | Care coordination outreach Next-best-action | Judith Soto: 4 claims, no attributed provider |
| 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.