Identities/MBR-002738

Gold, golden identity

Willie I Sims

6 source records from 3 feeds.

MBR-002738Verified6 records

Golden record

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

First namePRV: Willie
Middle namePRV: I
Last namePRV: Sims
Date of birthPRV: 1959-05-14
GenderPRV: F
Member IDPRV: UHC-08712-31
SSNPRV: •••-••-1054
PhonePRV: 3835495239
Email—: —
AddressPRV: 3094 Hillcrest Rd
CityPRV: Plano
StatePRV: TX
ZIPPRV: 75032
GroupCLM: GRP-9114
PlanPRV: OPTIONS-PPO

Min confidence

0.99

Sources

CLM ×2PRV ×3TPA ×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-430600	CLM	2026-01-09	Willie Simsflagged	1959-05-14	—	3835495239	3094 Hillcrest Rd # 975, Plano, TX	Scored	1.00	—
PRV-28950	PRV	2026-04-28	Willie Simsflagged	1959-05-14	UHC-08712-31	3835495239	3094 Hillcrest Rd, Plano, TX	Scored	1.00	—
PRV-28951	PRV	2026-04-28	Willie Simsflagged	1959-05-14	—	3835495239	3094 Hillcrest Rd, Plano, TX	Scored	1.00	—
CLM-430599	CLM	2026-05-19	Willie Smisflagged	1959-05-14	—	3835495239	3094 Hillcrest Rd, Plano, TX	Scored	0.99	—
PRV-28952	PRV	2026-05-26	Willie Simsflagged	1959-05-14	UHC-08712-31	3835495239	3094 Hillcrest Rd, Plano, TX	Scored	1.00	—
TPA-63515	TPA	2026-08-05	Willie Simsflagged	1959-05-14	UHC-08712-31	—	3094 Hillcrest Rd, Plano, TX	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-430600CLMPRV-28951PRV1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-28950PRVPRV-28951PRV1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-430600CLMPRV-28952PRV1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-28951PRVPRV-28952PRV1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-28951PRVTPA-63515TPA1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶PRV-28950PRVPRV-28952PRV0.99RuleD1 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
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶PRV-28950PRVTPA-63515TPA0.99RuleD1 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
SSN (last four)	1.00	2.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶PRV-28952PRVTPA-63515TPA0.99RuleD1 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
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-430600CLMCLM-430599CLM0.99Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.95	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-28950PRVCLM-430599CLM0.99Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.95	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-28951PRVCLM-430599CLM0.99Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.95	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-430599CLMPRV-28952PRV0.99Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.95	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-430599CLMTPA-63515TPA0.98Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.95	3
Date of birth	1.00	3	exact
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-430600CLMPRV-28950PRV0.97RuleD2 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
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-430600CLMTPA-63515TPA0.97RuleD2 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
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-430600 → UHC-08712-31 (Willie Sims)
ACT-007355, Claims processor
Orphan claim re-pointedExecuted
CLM-430599 → UHC-08712-31 (Willie Sims)
ACT-010193, Claims processor

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallyd52f6e7acf
scoring_agent, TPA-63515, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:54:38Record linked automatically8e1d4c77a1
scoring_agent, PRV-28952, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:54:38Record linked automaticallyee7dd9ae81
scoring_agent, CLM-430599, identity id MBR-002738, confidence 0.99, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:54:38Record linked automaticallyaa029cf780
scoring_agent, PRV-28951, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:54:38Record linked automaticallyacb05c5d85
scoring_agent, PRV-28950, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:54:38Record linked automatically6fcb2ebd74
scoring_agent, CLM-430600, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:52:08Record linked automatically3e8df2969a
scoring_agent, TPA-63515, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:52:08Record linked automaticallyd0cafec94b
scoring_agent, PRV-28952, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:52:08Record linked automaticallyb212733f2c
scoring_agent, CLM-430599, identity id MBR-002738, confidence 0.99, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:52:08Record linked automaticallyd4b02f268f
scoring_agent, PRV-28951, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:52:08Record linked automatically7ab914fea3
scoring_agent, PRV-28950, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:52:08Record linked automatically68972ae647
scoring_agent, CLM-430600, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:45:41Record linked automaticallyfb6ff91296
scoring_agent, TPA-63515, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:45:41Record linked automaticallycb38ff8b2d
scoring_agent, PRV-28952, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:45:41Record linked automatically4c2f31d256
scoring_agent, CLM-430599, identity id MBR-002738, confidence 0.99, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:45:41Record linked automaticallye6425040e5
scoring_agent, PRV-28951, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:45:41Record linked automatically3e8514abbc
scoring_agent, PRV-28950, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:45:41Record linked automatically3386ba1a80
scoring_agent, CLM-430600, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:32:31Record linked automaticallyc705f0034d
scoring_agent, TPA-63515, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:32:31Record linked automaticallyec25cbf2a9
scoring_agent, PRV-28952, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:32:31Record linked automaticallya7c0ad12a6
scoring_agent, CLM-430599, identity id MBR-002738, confidence 0.99, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:32:31Record linked automatically532603f02a
scoring_agent, PRV-28951, identity id MBR-002738, confidence 1, method probabilistic, matched record CLM-430600, policy version 1
2026-10-19 19:32:31Record linked automatically81f2e801ae
scoring_agent, PRV-28950, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:32:31Record linked automatically16729769c3
scoring_agent, CLM-430600, identity id MBR-002738, confidence 1, method probabilistic, matched record PRV-28951, policy version 1
2026-10-19 19:31:28Record linked automatically25d8ed5b5e
matching_agent, PRV-28950, identity id MBR-043460, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-140364
2026-10-19 19:31:28Record linked automaticallyff11b0e4ea
scoring_agent, PRV-28951, identity id MBR-024495, confidence 1, method probabilistic, matched record CLM-430591, policy version 1
2026-10-19 19:31:28Record linked automaticallydcb0e746e4
scoring_agent, TPA-63515, identity id MBR-010569, confidence 0.97, method probabilistic, matched record ENR-140668, policy version 1
2026-10-19 19:31:28Record linked automatically67c396f653
scoring_agent, PRV-28952, identity id MBR-009698, confidence 1, method probabilistic, matched record ENR-140376, policy version 1
2026-10-19 19:31:28Record linked automatically41926d3d85
scoring_agent, CLM-430599, identity id MBR-006517, confidence 1, method probabilistic, matched record TPA-63426, policy version 1
2026-10-19 19:31:28Record linked automatically53091bf079
matching_agent, CLM-430600, identity id MBR-006517, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-430599

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-2026-033707	2026-05-03	Northgate Cardiovascular Associates in network	93224	$270.00	$92.40	Approved	Approved
CLM-2026-022745	2025-12-26	Summit Primary Care Associates in network	99214, 99203	$432.00	—	Denied	Denied
CLM-2026-022744	2025-12-26	Summit Primary Care Associates in network	99214, 99203	$432.00	$242.84	Approved	Approved