Identities/MBR-003840

Gold, golden identity

Denise C Ramos

5 source records from 3 feeds.

MBR-003840Verified5 records

Golden record

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

First nameCLM: Denise
Middle nameENR: C
Last nameENR: Ramos
Date of birthENR: 1960-12-10
GenderENR: F
Member IDENR: UHC-80996-85
SSNENR: •••-••-3774
PhoneENR: 5257937763
EmailENR: denise.ramos@icloud.com
AddressENR: 899 Forest Ave
CityENR: Denver
StateENR: CO
ZIPENR: 80256
GroupENR: GRP-6240
PlanENR: NAVIGATE-HMO

Min confidence

0.99

Sources

CLM ×3ENR ×1TPA ×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-420524	CLM	2026-01-13	Denise Ramosflagged	1960-12-10	—	5257937763	899 Forest Ave, Denver, CO	Scored	1.00	—
CLM-420525	CLM	2026-05-08	Denise Ramosflagged	1960-12-10	UHC-80996-85	5257937763	899 Forest Ave # 582, Denver, CO	Scored	1.00	—
ENR-127001	ENR	2026-05-21	Denyse Ramosflagged	1960-12-10	UHC-80996-85	5257937763	899 Forest Ave, Denver, CO	Rule	0.99	D1 member id + dob exact
TPA-59021	TPA	2026-06-11	Denise Ramosflagged	1960-12-10	—	—	899 Forest Ave, Denver, CO	Scored	1.00	—
CLM-420523	CLM	2026-09-10	Denise Ramosflagged	1960-12-10	—	5257937763	—	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-420524CLMCLM-420523CLM1.00Scoredweighted 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-420525CLMCLM-420523CLM1.00Scoredweighted 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

▶TPA-59021TPACLM-420523CLM1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶ENR-127001ENR CLM-420523CLM0.99Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Email	1.00	1.5

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-420525CLMENR-127001ENR 0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
Member ID	1.00	4
SSN (last four)	1.00	2.5
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 4Conflicts: noneGuard: none

▶CLM-420524CLMCLM-420525CLM0.97RuleD2 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-420524CLMENR-127001ENR 0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	0.97	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-420524CLMTPA-59021TPA0.97RuleD2 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

▶CLM-420525CLMTPA-59021TPA0.97RuleD2 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

▶ENR-127001ENR TPA-59021TPA0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5
Email	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-420524 → UHC-80996-85 (Denise Ramos)
ACT-008971, Claims processor
Orphan claim re-pointedExecuted
CLM-420523 → UHC-80996-85 (Denise Ramos)
ACT-009656, Claims processor
Care coordination outreachProposed
Denise Ramos: 3 claims, no attributed provider
ACT-018063, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallyb002067f1a
scoring_agent, CLM-420523, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420524, policy version 1
2026-10-19 19:54:38Record linked automatically957d992162
scoring_agent, TPA-59021, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:54:38Record linked automaticallybcd3161c29
matching_agent, ENR-127001, identity id MBR-003840, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-420525
2026-10-19 19:54:38Record linked automaticallydb79ab5512
scoring_agent, CLM-420525, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:54:38Record linked automatically08a7c6da9a
scoring_agent, CLM-420524, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:52:08Record linked automatically643e4bdb95
scoring_agent, CLM-420523, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420524, policy version 1
2026-10-19 19:52:08Record linked automatically7db5f2e1c3
scoring_agent, TPA-59021, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:52:08Record linked automatically8425351242
matching_agent, ENR-127001, identity id MBR-003840, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-420525
2026-10-19 19:52:08Record linked automaticallyf297a18d0f
scoring_agent, CLM-420525, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:52:08Record linked automaticallyc3141eb54f
scoring_agent, CLM-420524, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:45:42Record linked automatically2228b9e52e
scoring_agent, CLM-420523, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420524, policy version 1
2026-10-19 19:45:42Record linked automatically42a2cc2494
scoring_agent, TPA-59021, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:45:42Record linked automatically26c9947a3c
matching_agent, ENR-127001, identity id MBR-003840, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-420525
2026-10-19 19:45:42Record linked automaticallye30cd41849
scoring_agent, CLM-420525, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:45:42Record linked automatically45110241f9
scoring_agent, CLM-420524, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:32:31Record linked automatically1eb776a302
scoring_agent, CLM-420523, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420524, policy version 1
2026-10-19 19:32:31Record linked automaticallye21f83fadc
scoring_agent, TPA-59021, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:32:31Record linked automatically0880b0d68e
matching_agent, ENR-127001, identity id MBR-003840, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-420525
2026-10-19 19:32:31Record linked automatically994b43eb75
scoring_agent, CLM-420525, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:32:31Record linked automaticallyad98138569
scoring_agent, CLM-420524, identity id MBR-003840, confidence 1, method probabilistic, matched record CLM-420523, policy version 1
2026-10-19 19:31:28Record linked automatically4b55018fa8
matching_agent, ENR-127001, identity id MBR-029811, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-58974
2026-10-19 19:31:28Record linked automatically0e8bc64eb8
matching_agent, CLM-420525, identity id MBR-013500, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-26010
2026-10-19 19:31:28Record linked automatically899122816a
scoring_agent, CLM-420523, identity id MBR-006077, confidence 1, method probabilistic, matched record CLM-420521, policy version 1
2026-10-19 19:31:28Record linked automaticallyd2ce1c414c
scoring_agent, TPA-59021, identity id MBR-004708, confidence 1, method probabilistic, matched record CLM-420693, 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-2026-031646	2026-09-07	Valley Internal Medicine Associates in network	99214, 80053	$332.00	$165.84	Approved	Approved
CLM-2026-008581	2026-04-13	Sunrise Diagnostic Imaging in network	74177, 77067	$2,904.00	$537.61	Approved	Approved
CLM-2026-028903	2026-01-11	Heritage Clinical Laboratories in network	87086	$39.00	$0.00	Approved	Approved