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

TypeAll Eligibility conflict resolved1,339 Orphan claim re-pointed9,112 Outreach address corrected2,993 Outreach suppressed pending steward4,326 Care coordination outreach1,815 New member onboarding2,081 Duplicate member record retired4,974

StatusAll proposed8,228 executed14,086 suppressed4,326 released0

Care coordination outreach, Next-best-action, 1,815 proposed

Action	Type	Title	Detail	Linked to	Status	Executed
ACT-017771	Care coordination outreach Next-best-action	Willie Martin: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000005	Proposed	—
ACT-017772	Care coordination outreach Next-best-action	Kimberly Marquez: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000016	Proposed	—
ACT-017773	Care coordination outreach Next-best-action	Michelle Carr: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000033	Proposed	—
ACT-017774	Care coordination outreach Next-best-action	Jack Yang: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000048	Proposed	—
ACT-017775	Care coordination outreach Next-best-action	Gerald Marquez: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000053	Proposed	—
ACT-017776	Care coordination outreach Next-best-action	Richard Santiago: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000123	Proposed	—
ACT-017777	Care coordination outreach Next-best-action	Kyle Kennedy: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000132	Proposed	—
ACT-017778	Care coordination outreach Next-best-action	Diego West: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000138	Proposed	—
ACT-017779	Care coordination outreach Next-best-action	Lauren Wang: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000146	Proposed	—
ACT-017780	Care coordination outreach Next-best-action	Kyle Phillips: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000157	Proposed	—
ACT-017781	Care coordination outreach Next-best-action	Robert Robinson: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000165	Proposed	—
ACT-017782	Care coordination outreach Next-best-action	Wayne Marshall: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000214	Proposed	—
ACT-017783	Care coordination outreach Next-best-action	Barbara Ruiz: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000222	Proposed	—
ACT-017784	Care coordination outreach Next-best-action	Gary Knight: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000224	Proposed	—
ACT-017785	Care coordination outreach Next-best-action	Pamela Matthews: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000234	Proposed	—
ACT-017786	Care coordination outreach Next-best-action	Albert Jacobs: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000235	Proposed	—
ACT-017787	Care coordination outreach Next-best-action	Raymond Walsh: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000241	Proposed	—
ACT-017788	Care coordination outreach Next-best-action	Judith Soto: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000244	Proposed	—
ACT-017789	Care coordination outreach Next-best-action	Joe Anderson: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000256	Proposed	—
ACT-017790	Care coordination outreach Next-best-action	Mateo Snyder: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000281	Proposed	—
ACT-017791	Care coordination outreach Next-best-action	Juan Snyder: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000301	Proposed	—
ACT-017792	Care coordination outreach Next-best-action	Megan Burton: 5 claims, no attributed provider	claims 5 recommendation assign PCP and schedule care-coordination call	MBR-000319	Proposed	—
ACT-017793	Care coordination outreach Next-best-action	Lori Contreras: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000324	Proposed	—
ACT-017794	Care coordination outreach Next-best-action	Sophia Lawrence: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000360	Proposed	—
ACT-017795	Care coordination outreach Next-best-action	Thomas Snyder: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000368	Proposed	—
ACT-017796	Care coordination outreach Next-best-action	Patrick Valdez: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000400	Proposed	—
ACT-017797	Care coordination outreach Next-best-action	Frank Price: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000413	Proposed	—
ACT-017798	Care coordination outreach Next-best-action	Albert Richards: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000416	Proposed	—
ACT-017799	Care coordination outreach Next-best-action	Susan Garrett: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000426	Proposed	—
ACT-017800	Care coordination outreach Next-best-action	Willie Le: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000447	Proposed	—
ACT-017801	Care coordination outreach Next-best-action	Gerald Dean: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000490	Proposed	—
ACT-017802	Care coordination outreach Next-best-action	Kayla Rice: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000509	Proposed	—
ACT-017803	Care coordination outreach Next-best-action	Stephanie Ruiz: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000519	Proposed	—
ACT-017804	Care coordination outreach Next-best-action	Joshua Holmes: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000524	Proposed	—
ACT-017805	Care coordination outreach Next-best-action	Willie Garcia: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000541	Proposed	—
ACT-017806	Care coordination outreach Next-best-action	Ann Adams: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000545	Proposed	—
ACT-017807	Care coordination outreach Next-best-action	Alice Ortiz: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000574	Proposed	—
ACT-017808	Care coordination outreach Next-best-action	Vincent Morgan: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000577	Proposed	—
ACT-017809	Care coordination outreach Next-best-action	Sandra Kim: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000585	Proposed	—
ACT-017810	Care coordination outreach Next-best-action	Sara Burton: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000599	Proposed	—
ACT-017811	Care coordination outreach Next-best-action	Frank Howard: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000609	Proposed	—
ACT-017812	Care coordination outreach Next-best-action	Martha Weaver: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000625	Proposed	—
ACT-017813	Care coordination outreach Next-best-action	Kathleen Hanson: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000630	Proposed	—
ACT-017814	Care coordination outreach Next-best-action	Susan Ward: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000634	Proposed	—
ACT-017815	Care coordination outreach Next-best-action	Jessica Vargas: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000636	Proposed	—
ACT-017816	Care coordination outreach Next-best-action	Arthur Turner: 3 claims, no attributed provider	claims 3 recommendation assign PCP and schedule care-coordination call	MBR-000642	Proposed	—
ACT-017817	Care coordination outreach Next-best-action	Emma Silva: 5 claims, no attributed provider	claims 5 recommendation assign PCP and schedule care-coordination call	MBR-000644	Proposed	—
ACT-017818	Care coordination outreach Next-best-action	Mike Simmons: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000648	Proposed	—
ACT-017819	Care coordination outreach Next-best-action	Martha Rodriguez: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000708	Proposed	—
ACT-017820	Care coordination outreach Next-best-action	Fatima Cook: 4 claims, no attributed provider	claims 4 recommendation assign PCP and schedule care-coordination call	MBR-000710	Proposed	—

1,815 rows, page 1 of 37Previous Next

Derivation rules

Evaluated after every gold rebuild

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
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
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
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
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
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
Duplicate member record retired
Two or more enrollment records collapsed into one identity. Member services retires the extra cards against the surviving member ID.