Identities/MBR-004464

Gold, golden identity

Robert Simmons

4 source records from 2 feeds.

MBR-004464Verified4 records

Golden record

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

First namePRV: Robert
Middle name—: —
Last namePRV: Simmons
Date of birthPRV: 1947-10-08
GenderPRV: F
Member IDPRV: UHC-52762-25
SSNPRV: •••-••-1485
PhonePRV: 5082913918
EmailPRV: robert.simmons73@yahoo.com
AddressPRV: 1818 Maple Ave
CityPRV: San Diego
StatePRV: CA
ZIPPRV: 92157
Group—: —
PlanCLM: MEDICARE-ADV-A

Min confidence

0.96

Sources

CLM ×3PRV ×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-412792	CLM	2026-01-15	Robert Simmonsflagged	1947-10-08	UHC-52762-25	5082913918	1818 Maple Ave, San Diego, CA	Rule	0.99	D1 member id + dob exact
PRV-23696	PRV	2026-02-23	Robert Simmonsflagged	1947-10-08	UHC-52762-25	5082913918	1818 Maple Ave, San Diego, CA	Rule	0.99	D1 member id + dob exact
CLM-412791	CLM	2026-08-12	Robert Simmonsflagged	—	UHC-52762-25	—	1818 Maple Ave, San Diego, CA	Rule	0.96	D3 member id + name
CLM-412790	CLM	2026-08-12	Robert Simmonsflagged	—	UHC-52762-25	—	1818 Maple Ave, San Diego, CA	Rule	0.96	D3 member id + name

Evidence

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

A

B

Score

Method

Rule

Decision

▶CLM-412792CLMPRV-23696PRV0.99RuleD1 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
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 4Conflicts: noneGuard: none

▶CLM-412792CLMCLM-412790CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-23696PRVCLM-412790CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-412791CLMCLM-412790CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-412792CLMCLM-412791CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶PRV-23696PRVCLM-412791CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Eligibility conflict resolvedProposed
Robert Simmons: 2 plan codes across sources → canonical MEDICARE-ADV-A
ACT-000225, Eligibility engine

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallya3f6075a19
matching_agent, CLM-412790, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:54:38Record linked automaticallya3022be620
matching_agent, CLM-412791, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:54:38Record linked automaticallye6e13d21ce
matching_agent, PRV-23696, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-412792
2026-10-19 19:54:38Record linked automaticallyec13c205aa
matching_agent, CLM-412792, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-23696
2026-10-19 19:52:08Record linked automatically6dbb79c149
matching_agent, CLM-412790, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:52:08Record linked automatically0360922a35
matching_agent, CLM-412791, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:52:08Record linked automaticallyed10cfe9f5
matching_agent, PRV-23696, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-412792
2026-10-19 19:52:08Record linked automatically0918619fae
matching_agent, CLM-412792, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-23696
2026-10-19 19:45:42Record linked automatically9519416401
matching_agent, CLM-412790, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:45:42Record linked automatically92a7139410
matching_agent, CLM-412791, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:45:42Record linked automatically45cee9784e
matching_agent, PRV-23696, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-412792
2026-10-19 19:45:42Record linked automatically9f9025489d
matching_agent, CLM-412792, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-23696
2026-10-19 19:32:31Record linked automaticallyc38f7047fd
matching_agent, CLM-412790, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:32:31Record linked automatically67e6867484
matching_agent, CLM-412791, identity id MBR-004464, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-412792
2026-10-19 19:32:31Record linked automatically977849c9c0
matching_agent, PRV-23696, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-412792
2026-10-19 19:32:31Record linked automatically203c67f456
matching_agent, CLM-412792, identity id MBR-004464, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-23696
2026-10-19 19:31:28Record linked automatically2593134572
scoring_agent, CLM-412792, identity id MBR-028385, confidence 0.99, method probabilistic, matched record PRV-23774, policy version 1
2026-10-19 19:31:28Record linked automaticallyba5d9ea3a9
scoring_agent, CLM-412791, identity id MBR-008840, confidence 1, method probabilistic, matched record CLM-412789, policy version 1
2026-10-19 19:31:28Record linked automatically198bdfcf62
scoring_agent, PRV-23696, identity id MBR-001053, confidence 1, method probabilistic, matched record ENR-116575, policy version 1

Claims for this member

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

Claim	Service	Provider	Procedures	Billed	Plan paid	Rules	Status
CLM-2026-030183	2026-07-15	Riverside Bone and Joint Center out of network	27447	$29,506.00	—	Denied	Denied
CLM-2026-008292	2026-06-29	Mesa Clinical Laboratories in network	80061, 85025, 80053	$167.00	—	Denied	Denied
CLM-2026-015727	2026-01-03	Mesa Imaging Center out of network	74177	$2,005.00	—	Needs review	Needs review