Identities/MBR-001356

Gold, golden identity

Charlotte M Ortiz

6 source records from 3 feeds.

MBR-001356Verified6 records

Golden record

Source priority ENR > PRV > CLM > TPA; most recent value for phone, email, address_line1, city, state, zip

First nameCLM: Charlotte
Middle nameENR: M
Last nameCLM: Ortiz
Date of birthENR: 2002-10-16
GenderENR: F
Member IDENR: UHC-52389-49
SSNENR: •••-••-5359
PhoneCLM: 4594479762
EmailENR: charlotte.ortiz80@aol.com
AddressENR: 7944 Canyon Rd
CityENR: Columbus
StateENR: OH
ZIPENR: 43239
GroupENR: GRP-7783
PlanENR: OPTIONS-PPO

Min confidence

0.98

Sources

CLM ×4TPA ×1ENR ×1

Updated

2026-10-19 19:54:36

run-mvfoap9e

Identity graph

Source records linked to this identity and the confidence of each link

Golden identityEnrollmentClaimsProvider networkThird-party administratorAuto link (at or above 0.85)Below thresholdSteward link

Linked source records

Silver values for each record in the cluster, and how it was attached

Record	Source	Received	Name	DOB	Member ID	Phone	Address	Method	Confidence	Rule
CLM-400267	CLM	2026-01-05	Charlotte Ortizflagged	2002-10-16	UHC-52389-49	4594479762	—	Scored	1.00	—
CLM-400264	CLM	2026-04-16	Charlotte Ortizflagged	2002-10-16	UHC-52389-49	4594479762	7944 Canyon Rd, Columbus, OH	Scored	1.00	—
TPA-50112	TPA	2026-04-27	Charlotte Ortyzflagged	2002-10-16	—	—	7944 Canyon Rd, Columbus, OH	Scored	0.98	—
CLM-400266	CLM	2026-07-21	Charlotte Ortizflagged	2002-10-16	—	4594479762	7944 Canyon Rd, Columbus, OH	Scored	1.00	—
ENR-100369	ENR	2026-07-27	Charltote Oritzflagged	2002-10-16	UHC-52389-49	—	7944 Canyon Rd, Columbus, OH	Rule	0.99	D1 member id + dob exact
CLM-400265	CLM	2026-10-05	Charlotte Ortizflagged	2002-10-16	—	4594479762	—	Scored	1.00	—

Evidence

15 scored pairs among these records, expand a row for the per-field comparison

Score

Method

Rule

Decision

▶CLM-400264CLMCLM-400265CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-400266CLMCLM-400265CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-400267CLMCLM-400266CLM1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-400267CLMCLM-400264CLM0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Phone	1.00	1.5

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-400267CLMENR-100369ENR 0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	0.96	3
Date of birth	1.00	3	exact
Member ID	1.00	4
SSN (last four)	1.00	2.5

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-400264CLMENR-100369ENR 0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	0.96	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Address	0.70	2	street_match

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-400266CLMENR-100369ENR 0.99Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.96	3
Date of birth	1.00	3	exact
Email	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-50112TPACLM-400266CLM0.98Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.94	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶TPA-50112TPAENR-100369ENR 0.97Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.93	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-400267CLMCLM-400265CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5
Phone	1.00	1.5

Identifiers agreeing: 2Conflicts: noneGuard: none

▶ENR-100369ENR CLM-400265CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	0.96	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-400264CLMCLM-400266CLM0.94Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	0.70	2	street_match

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-400264CLMTPA-50112TPA0.90Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.94	3
Date of birth	1.00	3	exact
Address	0.70	2	street_match

Identifiers agreeing: 1Conflicts: noneGuard: none

▶TPA-50112TPACLM-400265CLM0.83Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	0.94	3
Date of birth	1.00	3	exact

Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

▶CLM-400267CLMTPA-50112TPA0.83Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	0.94	3
Date of birth	1.00	3	exact

Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-400266 → UHC-52389-49 (Charlotte Ortiz)
ACT-005689, Claims processor
Orphan claim re-pointedExecuted
CLM-400265 → UHC-52389-49 (Charlotte Ortiz)
ACT-007377, Claims processor
Care coordination outreachProposed
Charlotte Ortiz: 4 claims, no attributed provider
ACT-017878, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automatically3df9885347
scoring_agent, CLM-400265, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400264, policy version 1
2026-10-19 19:54:38Record linked automaticallye4c14af3d1
matching_agent, ENR-100369, identity id MBR-001356, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400267
2026-10-19 19:54:38Record linked automatically5d8f016fc4
scoring_agent, CLM-400266, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400267, policy version 1
2026-10-19 19:54:38Record linked automaticallyfecb105bb3
scoring_agent, TPA-50112, identity id MBR-001356, confidence 0.98, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:54:38Record linked automatically1e435f0085
scoring_agent, CLM-400264, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400265, policy version 1
2026-10-19 19:54:38Record linked automatically4c403a538c
scoring_agent, CLM-400267, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:52:08Record linked automatically63de3981bf
scoring_agent, CLM-400265, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400264, policy version 1
2026-10-19 19:52:08Record linked automaticallyf2280f8be6
matching_agent, ENR-100369, identity id MBR-001356, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400267
2026-10-19 19:52:08Record linked automaticallyeca3b11579
scoring_agent, CLM-400266, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400267, policy version 1
2026-10-19 19:52:08Record linked automaticallyc078ac4ea0
scoring_agent, TPA-50112, identity id MBR-001356, confidence 0.98, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:52:08Record linked automaticallyb2362c985f
scoring_agent, CLM-400264, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400265, policy version 1
2026-10-19 19:52:08Record linked automatically9b860cc870
scoring_agent, CLM-400267, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:45:41Record linked automatically371f3a17ca
scoring_agent, CLM-400265, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400264, policy version 1
2026-10-19 19:45:41Record linked automatically4fe4677dc3
matching_agent, ENR-100369, identity id MBR-001356, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400267
2026-10-19 19:45:41Record linked automatically2052d0ef2c
scoring_agent, CLM-400266, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400267, policy version 1
2026-10-19 19:45:41Record linked automaticallyc293e5b524
scoring_agent, TPA-50112, identity id MBR-001356, confidence 0.98, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:45:41Record linked automaticallyf6c5a2c47e
scoring_agent, CLM-400264, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400265, policy version 1
2026-10-19 19:45:41Record linked automaticallyb1df8f43c6
scoring_agent, CLM-400267, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:32:31Record linked automatically3079a6e0c1
scoring_agent, CLM-400265, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400264, policy version 1
2026-10-19 19:32:31Record linked automatically697dc8972c
matching_agent, ENR-100369, identity id MBR-001356, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400267
2026-10-19 19:32:31Record linked automaticallyfb6999e8e3
scoring_agent, CLM-400266, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400267, policy version 1
2026-10-19 19:32:31Record linked automaticallyd6f4bf9981
scoring_agent, TPA-50112, identity id MBR-001356, confidence 0.98, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:32:31Record linked automatically1c1b434a65
scoring_agent, CLM-400264, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400265, policy version 1
2026-10-19 19:32:31Record linked automaticallyad637da50f
scoring_agent, CLM-400267, identity id MBR-001356, confidence 1, method probabilistic, matched record CLM-400266, policy version 1
2026-10-19 19:31:28Record linked automaticallycc2957e6ef
matching_agent, ENR-100369, identity id MBR-032835, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400254
2026-10-19 19:31:28Record linked automatically56fd103e17
scoring_agent, TPA-50112, identity id MBR-029820, confidence 1, method probabilistic, matched record CLM-400262, policy version 1
2026-10-19 19:31:28Record linked automaticallyb65e70602e
matching_agent, CLM-400265, identity id MBR-029740, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-20076
2026-10-19 19:31:28Record linked automatically23d1335802
matching_agent, CLM-400264, identity id MBR-016798, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record CLM-400263
2026-10-19 19:31:28Record linked automatically6221083576
scoring_agent, CLM-400266, identity id MBR-010276, confidence 1, method probabilistic, matched record CLM-400267, policy version 1
2026-10-19 19:31:28Record linked automatically0e600b3630
scoring_agent, CLM-400267, identity id MBR-010276, confidence 1, method probabilistic, matched record CLM-400266, policy version 1

Claims for this member

Claims attached through the identity graph; holds follow open steward cases automatically

All claims

Claim	Service	Provider	Procedures	Billed	Plan paid	Rules	Status
CLM-2026-022834	2026-09-27	Mesa Medical Group in network	99214	$272.00	—	Denied	Denied
CLM-2026-022833	2026-09-27	Mesa Medical Group in network	99214	$272.00	$148.64	Approved	Approved
CLM-2026-016449	2026-07-18	Canyon Primary Care Associates in network	99395	$335.00	$187.70	Approved	Approved
CLM-2026-031922	2026-03-15	Desert Primary Care Associates in network	90471, 36415	$61.00	$17.82	Approved	Approved
CLM-2026-020849	2026-01-01	Riverside Imaging Center in network	70553	$2,250.00	$0.00	Approved	Approved