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 suppressed
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-000001 | Eligibility conflict resolved Eligibility engine | Willie Martin: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000002 | Eligibility conflict resolved Eligibility engine | Marilyn Rojas: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000003 | Eligibility conflict resolved Eligibility engine | Camila Webb: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000004 | Eligibility conflict resolved Eligibility engine | Timothy Brown: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000005 | Eligibility conflict resolved Eligibility engine | Sara Baker: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000006 | Eligibility conflict resolved Eligibility engine | Ethan Jackson: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000007 | Eligibility conflict resolved Eligibility engine | Diana Reid: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000008 | Eligibility conflict resolved Eligibility engine | Tyler Ramirez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000009 | Eligibility conflict resolved Eligibility engine | Amber Lee: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000010 | Eligibility conflict resolved Eligibility engine | Jean Wang: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000011 | Eligibility conflict resolved Eligibility engine | Henry Hunter: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000012 | Eligibility conflict resolved Eligibility engine | Amanda Bennett: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000013 | Eligibility conflict resolved Eligibility engine | Christina Olson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000014 | Eligibility conflict resolved Eligibility engine | Jose Barnes: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000015 | Eligibility conflict resolved Eligibility engine | James Stewart: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000016 | Eligibility conflict resolved Eligibility engine | Thomas Snyder: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000017 | Eligibility conflict resolved Eligibility engine | Hiroshi Vazquez: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000018 | Eligibility conflict resolved Eligibility engine | Susan Garrett: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000019 | Eligibility conflict resolved Eligibility engine | Philip Carpenter: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000020 | Eligibility conflict resolved Eligibility engine | Daniel Larson: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000021 | Eligibility conflict resolved Eligibility engine | Jeffrey Myers: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000022 | Eligibility conflict resolved Eligibility engine | Gary Espinoza: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000023 | Eligibility conflict resolved Eligibility engine | Willie Garcia: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000024 | Eligibility conflict resolved Eligibility engine | Jean Pena: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000025 | Eligibility conflict resolved Eligibility engine | Ann Adams: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000026 | Eligibility conflict resolved Eligibility engine | Jacqueline Burke: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000027 | Eligibility conflict resolved Eligibility engine | Lisa Morales: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000028 | Eligibility conflict resolved Eligibility engine | Tyler Rojas: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000029 | Eligibility conflict resolved Eligibility engine | Christine Morgan: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000030 | Eligibility conflict resolved Eligibility engine | Doris Garrett: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000031 | Eligibility conflict resolved Eligibility engine | Susan Ward: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000032 | Eligibility conflict resolved Eligibility engine | Jessica Vargas: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000033 | Eligibility conflict resolved Eligibility engine | Nicole Snyder: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000034 | Eligibility conflict resolved Eligibility engine | Nancy Bishop: 2 plan codes across sources → canonical CHOICE-PLUS-PPO |
| Proposed | — | ||
| ACT-000035 | Eligibility conflict resolved Eligibility engine | Zachary Bryant: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000036 | Eligibility conflict resolved Eligibility engine | Omar Ortiz: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000037 | Eligibility conflict resolved Eligibility engine | Nicole Riley: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000038 | Eligibility conflict resolved Eligibility engine | Danielle King: 2 plan codes across sources → canonical MEDICARE-ADV-B |
| Proposed | — | ||
| ACT-000039 | Eligibility conflict resolved Eligibility engine | Julia Carlson: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000040 | Eligibility conflict resolved Eligibility engine | Diego Contreras: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000041 | Eligibility conflict resolved Eligibility engine | Ralph Graham: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000042 | Eligibility conflict resolved Eligibility engine | Judith Maldonado: 2 plan codes across sources → canonical CORE-HMO |
| Proposed | — | ||
| ACT-000043 | Eligibility conflict resolved Eligibility engine | Kimberly Dixon: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000044 | Eligibility conflict resolved Eligibility engine | Grace Little: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000045 | Eligibility conflict resolved Eligibility engine | Adam Burns: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000046 | Eligibility conflict resolved Eligibility engine | Jerry Anderson: 2 plan codes across sources → canonical MEDICARE-ADV-A |
| Proposed | — | ||
| ACT-000047 | Eligibility conflict resolved Eligibility engine | Christopher Thomas: 2 plan codes across sources → canonical OPTIONS-PPO |
| Proposed | — | ||
| ACT-000048 | Eligibility conflict resolved Eligibility engine | Sandra White: 2 plan codes across sources → canonical NAVIGATE-HMO |
| Proposed | — | ||
| ACT-000049 | Eligibility conflict resolved Eligibility engine | Sean Berry: 2 plan codes across sources → canonical SELECT-EPO |
| Proposed | — | ||
| ACT-000050 | Eligibility conflict resolved Eligibility engine | Kyle Contreras: 2 plan codes across sources → canonical SELECT-EPO |
| 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.