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-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.