Operate, actions

Actions

Downstream actions derived from the resolved identities. Proposed actions wait for an operator; suppressed actions wait for a steward decision.

Actions

26,640 derived from the last resolution run

ActionTypeTitleDetailLinked toStatusExecuted
ACT-018239
Care coordination outreach
Next-best-action
Gabriel Roberts: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018240
Care coordination outreach
Next-best-action
Gregory Perez: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018241
Care coordination outreach
Next-best-action
Walter Hunt: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018242
Care coordination outreach
Next-best-action
Nicole Gonzales: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018243
Care coordination outreach
Next-best-action
Emily Ramirez: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018244
Care coordination outreach
Next-best-action
Benjamin Gibson: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018245
Care coordination outreach
Next-best-action
Dylan Alexander: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018246
Care coordination outreach
Next-best-action
Samantha Reid: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018247
Care coordination outreach
Next-best-action
Bobby Chapman: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018248
Care coordination outreach
Next-best-action
Jacqueline Ryan: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018249
Care coordination outreach
Next-best-action
Scott Ward: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018250
Care coordination outreach
Next-best-action
Mary Jordan: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018251
Care coordination outreach
Next-best-action
Sharon Bell: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018252
Care coordination outreach
Next-best-action
Priya Spencer: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018253
Care coordination outreach
Next-best-action
Brittany Hudson: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018254
Care coordination outreach
Next-best-action
Ronald Herrera: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018255
Care coordination outreach
Next-best-action
Jordan Duncan: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018256
Care coordination outreach
Next-best-action
Ana Mason: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018257
Care coordination outreach
Next-best-action
Ryan Edwards: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018258
Care coordination outreach
Next-best-action
Ralph Fuller: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018259
Care coordination outreach
Next-best-action
Tyler Gomez: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018260
Care coordination outreach
Next-best-action
Jessica Williamson: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018261
Care coordination outreach
Next-best-action
Ana Banks: 4 claims, no attributed provider
Claims
4
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018262
Care coordination outreach
Next-best-action
Pamela Yang: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018263
Care coordination outreach
Next-best-action
Scott Johnston: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018264
Care coordination outreach
Next-best-action
Sam Miller: 5 claims, no attributed provider
Claims
5
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018265
Care coordination outreach
Next-best-action
Debra Elliott: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018266
Care coordination outreach
Next-best-action
Brandon Sandoval: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018267
Care coordination outreach
Next-best-action
Gregory Delgado: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018268
Care coordination outreach
Next-best-action
Jonathan Davis: 4 claims, no attributed provider
Claims
4
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018269
Care coordination outreach
Next-best-action
Ruth Fisher: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018270
Care coordination outreach
Next-best-action
Doris Nunez: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018271
Care coordination outreach
Next-best-action
Ashley Bowman: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018272
Care coordination outreach
Next-best-action
Don Richardson: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018273
Care coordination outreach
Next-best-action
Patricia Marshall: 4 claims, no attributed provider
Claims
4
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018274
Care coordination outreach
Next-best-action
Helen Wright: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018275
Care coordination outreach
Next-best-action
Bryan Carter: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018276
Care coordination outreach
Next-best-action
Nathan Riley: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018277
Care coordination outreach
Next-best-action
Keith Kennedy: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018278
Care coordination outreach
Next-best-action
Brenda Elliott: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018279
Care coordination outreach
Next-best-action
Patricia Parker: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018280
Care coordination outreach
Next-best-action
Logan Hamilton: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018281
Care coordination outreach
Next-best-action
Lauren Hill: 4 claims, no attributed provider
Claims
4
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018282
Care coordination outreach
Next-best-action
Gabriel Gonzalez: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018283
Care coordination outreach
Next-best-action
Sophia Jacobs: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018284
Care coordination outreach
Next-best-action
Nicole Hamilton: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018285
Care coordination outreach
Next-best-action
Judith Jacobs: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018286
Care coordination outreach
Next-best-action
Dorothy Austin: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018287
Care coordination outreach
Next-best-action
Jesse Armstrong: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
ACT-018288
Care coordination outreach
Next-best-action
Ashley Bowman: 3 claims, no attributed provider
Claims
3
Recommendation
assign PCP and schedule care-coordination call
Proposed—
26,640 rows, page 97 of 533PreviousNext

Derivation rules

Evaluated after every gold rebuild

  1. 1
    Eligibility conflict resolved
    The records behind one identity disagree on plan code. Survivorship picks the enrollment plan; the eligibility engine is told which one is canonical.
  2. 2
    Orphan claim re-pointed
    A 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.
  3. 3
    Outreach address corrected
    The most recent address on the golden record differs from what enrollment holds. Outreach gets the current address before the next mailing.
  4. 4
    Outreach suppressed pending steward
    The record is sitting in an open steward case. Nothing sensitive is sent until a person decides, so we never message the wrong member.
  5. 5
    Care coordination outreach
    Three or more claims and no provider record. Next-best-action proposes assigning a PCP and scheduling a care-coordination call.
  6. 6
    New member onboarding
    A single, fresh enrollment with no other activity yet. Next-best-action proposes the welcome kit and a digital ID card.
  7. 7
    Duplicate member record retired
    Two or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.