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-000401 | Eligibility conflict resolved Eligibility engine | Jacqueline Mason: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000402 | Eligibility conflict resolved Eligibility engine | Deborah Holmes: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000403 | Eligibility conflict resolved Eligibility engine | Austin Warren: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000404 | Eligibility conflict resolved Eligibility engine | Ashley Carpenter: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000405 | Eligibility conflict resolved Eligibility engine | Joe Evans: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000406 | Eligibility conflict resolved Eligibility engine | Justin Rios: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000407 | Eligibility conflict resolved Eligibility engine | Albert Crawford: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000408 | Eligibility conflict resolved Eligibility engine | Jose Morrison: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000409 | Eligibility conflict resolved Eligibility engine | Fatima Robertson: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000410 | Eligibility conflict resolved Eligibility engine | Steven Ramos: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000411 | Eligibility conflict resolved Eligibility engine | Carolyn Fisher: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000412 | Eligibility conflict resolved Eligibility engine | Kyle Meyer: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000413 | Eligibility conflict resolved Eligibility engine | Mark Hicks: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000414 | Eligibility conflict resolved Eligibility engine | Scott Moreno: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000415 | Eligibility conflict resolved Eligibility engine | Hiroshi Day: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000416 | Eligibility conflict resolved Eligibility engine | Thomas Matthews: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000417 | Eligibility conflict resolved Eligibility engine | Julie Knight: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000418 | Eligibility conflict resolved Eligibility engine | Harold Mejia: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000419 | Eligibility conflict resolved Eligibility engine | Janice Holmes: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000420 | Eligibility conflict resolved Eligibility engine | Albert Delgado: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000421 | Eligibility conflict resolved Eligibility engine | Catherine Fuller: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000422 | Eligibility conflict resolved Eligibility engine | Emily Cooper: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000423 | Eligibility conflict resolved Eligibility engine | Ahmed Jackson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000424 | Eligibility conflict resolved Eligibility engine | Danielle Peterson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000425 | Eligibility conflict resolved Eligibility engine | Barbara Weber: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000426 | Eligibility conflict resolved Eligibility engine | Keith Garcia: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000427 | Eligibility conflict resolved Eligibility engine | Gerald Patterson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000428 | Eligibility conflict resolved Eligibility engine | Jesse Reyes: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000429 | Eligibility conflict resolved Eligibility engine | Jesse Jones: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000430 | Eligibility conflict resolved Eligibility engine | Charles Boyd: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000431 | Eligibility conflict resolved Eligibility engine | Jerry Cole: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000432 | Eligibility conflict resolved Eligibility engine | Chris Ryan: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000433 | Eligibility conflict resolved Eligibility engine | Sara Powell: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000434 | Eligibility conflict resolved Eligibility engine | Larry Singh: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000435 | Eligibility conflict resolved Eligibility engine | Rachel Maldonado: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000436 | Eligibility conflict resolved Eligibility engine | Mary Ross: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000437 | Eligibility conflict resolved Eligibility engine | Sean Henderson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000438 | Eligibility conflict resolved Eligibility engine | Christine Sims: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000439 | Eligibility conflict resolved Eligibility engine | Amy Vargas: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000440 | Eligibility conflict resolved Eligibility engine | Samantha Kelly: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000441 | Eligibility conflict resolved Eligibility engine | Ralph Kelley: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000442 | Eligibility conflict resolved Eligibility engine | William Ferguson: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000443 | Eligibility conflict resolved Eligibility engine | Austin Torres: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000444 | Eligibility conflict resolved Eligibility engine | Luis Jones: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000445 | Eligibility conflict resolved Eligibility engine | Ethan Ruiz: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000446 | Eligibility conflict resolved Eligibility engine | Jennifer Hawkins: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000447 | Eligibility conflict resolved Eligibility engine | Victoria Greene: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000448 | Eligibility conflict resolved Eligibility engine | Daniel Alvarez: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000449 | Eligibility conflict resolved Eligibility engine | Lucia Hawkins: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000450 | Eligibility conflict resolved Eligibility engine | Raymond Hicks: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| 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.