Identities/MBR-004647

Gold, golden identity

Denise I Ortega

5 source records from 2 feeds.

MBR-004647Verified5 records

Golden record

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

First nameENR: Denise
Middle nameCLM: I
Last nameENR: Ortega
Date of birthENR: 2005-09-20
GenderENR: F
Member IDENR: UHC-19461-15
SSNENR: •••-••-3734
PhoneENR: 5596106358
EmailENR: denise.ortega99@outlook.com
AddressENR: 7305 Maple Ave
CityENR: Seattle
StateENR: WA
ZIPENR: 98162
GroupENR: GRP-2791
PlanENR: OPTIONS-PPO

Min confidence

0.88

Sources

CLM ×4ENR ×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-413792	CLM	2026-01-15	Denise Ortegaflagged	2005-09-20	—	5596106358	7305 Maple Ave, Seattle, WA	Scored	1.00	—
CLM-413793	CLM	2026-05-31	Denise Ortegaflagged	2005-09-20	UHC-19461-15	5596106358	7305 Maple Ave, Seattle, WA	Scored	1.00	—
CLM-413794	CLM	2026-07-04	Denise Ortegaflagged	2005-09-20	UHC-19461-15	—	—	Rule	0.99	D1 member id + dob exact
ENR-118032	ENR	2026-07-26	Denise Ortegaflagged	2005-09-20	UHC-19461-15	5596106358	7305 Maple Ave, Seattle, WA	Scored	1.00	—
CLM-413795	CLM	2026-07-29	Denise Ortegaflagged	2006-09-20	—	5596106358	7305 Maple Ave, Seattle, WA	Scored	0.88	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-413792CLMCLM-413793CLM1.00Scoredweighted 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-413792CLMENR-118032ENR1.00Scoredweighted 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-413793CLMCLM-413794CLM0.99RuleD1 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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-413793CLMENR-118032ENR0.99RuleD1 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

▶CLM-413794CLMENR-118032ENR0.99RuleD1 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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶ENR-118032ENRCLM-413795CLM0.88Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	0.50	3	one_digit
SSN (last four)	1.00	2.5
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-413792CLMCLM-413795CLM0.84Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	0.50	3	one_digit
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-413793CLMCLM-413795CLM0.84Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	0.50	3	one_digit
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-413792CLMCLM-413794CLM0.83Scoredweighted similaritySent to steward

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

Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

▶CLM-413794CLMCLM-413795CLM0.75Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	0.50	3	one_digit

Identifiers agreeing: 0Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-413792 → UHC-19461-15 (Denise Ortega)
ACT-005387, Claims processor
Orphan claim re-pointedExecuted
CLM-413795 → UHC-19461-15 (Denise Ortega)
ACT-005939, Claims processor
Care coordination outreachProposed
Denise Ortega: 4 claims, no attributed provider
ACT-018138, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automatically1817a46f9d
scoring_agent, CLM-413795, identity id MBR-004647, confidence 0.88, method probabilistic, matched record ENR-118032, policy version 1
2026-10-19 19:54:38Record linked automaticallya2d0196a71
scoring_agent, ENR-118032, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:54:38Record linked automatically4336831fa7
matching_agent, CLM-413794, identity id MBR-004647, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-413793
2026-10-19 19:54:38Record linked automaticallya86e53fc80
scoring_agent, CLM-413793, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:54:38Record linked automatically71432b3af4
scoring_agent, CLM-413792, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413793, policy version 1
2026-10-19 19:52:08Record linked automaticallyffacbbb43e
scoring_agent, CLM-413795, identity id MBR-004647, confidence 0.88, method probabilistic, matched record ENR-118032, policy version 1
2026-10-19 19:52:08Record linked automaticallyf2faaa36f5
scoring_agent, ENR-118032, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:52:08Record linked automatically6d7b1b3fd8
matching_agent, CLM-413794, identity id MBR-004647, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-413793
2026-10-19 19:52:08Record linked automaticallyd50a977d7a
scoring_agent, CLM-413793, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:52:08Record linked automatically3dc8a2a9d3
scoring_agent, CLM-413792, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413793, policy version 1
2026-10-19 19:45:42Record linked automatically3e6f9aaddd
scoring_agent, CLM-413795, identity id MBR-004647, confidence 0.88, method probabilistic, matched record ENR-118032, policy version 1
2026-10-19 19:45:42Record linked automatically25b3e4da74
scoring_agent, ENR-118032, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:45:42Record linked automatically272f52fabe
matching_agent, CLM-413794, identity id MBR-004647, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-413793
2026-10-19 19:45:42Record linked automatically985c7bbce7
scoring_agent, CLM-413793, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:45:42Record linked automaticallye9b614c644
scoring_agent, CLM-413792, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413793, policy version 1
2026-10-19 19:32:31Record linked automatically6f97382814
scoring_agent, CLM-413795, identity id MBR-004647, confidence 0.88, method probabilistic, matched record ENR-118032, policy version 1
2026-10-19 19:32:31Record linked automaticallyce4750b738
scoring_agent, ENR-118032, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:32:31Record linked automatically64c9c0c0c6
matching_agent, CLM-413794, identity id MBR-004647, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-413793
2026-10-19 19:32:31Record linked automaticallyb15c0229df
scoring_agent, CLM-413793, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:32:31Record linked automatically9ee72fe232
scoring_agent, CLM-413792, identity id MBR-004647, confidence 1, method probabilistic, matched record CLM-413793, policy version 1
2026-10-19 19:31:28Record linked automatically5656059145
scoring_agent, ENR-118032, identity id MBR-005226, confidence 1, method probabilistic, matched record CLM-413691, policy version 1
2026-10-19 19:31:28Record linked automatically5411ef68dc
scoring_agent, CLM-413792, identity id MBR-003545, confidence 1, method probabilistic, matched record CLM-413793, policy version 1
2026-10-19 19:31:28Record linked automaticallya613da992e
scoring_agent, CLM-413793, identity id MBR-003545, confidence 1, method probabilistic, matched record CLM-413792, policy version 1
2026-10-19 19:31:28Record linked automatically75ff985d8b
scoring_agent, CLM-413794, identity id MBR-000855, confidence 1, method probabilistic, matched record CLM-413795, policy version 1
2026-10-19 19:31:28Record linked automatically6afaf08e17
scoring_agent, CLM-413795, identity id MBR-000855, confidence 1, method probabilistic, matched record ENR-118140, 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-2026-017311	2026-06-30	Mesa Clinical Laboratories in network	85025, 87086	$110.00	$6.24	Approved	Approved
CLM-2026-013692	2026-06-26	Cornerstone Family Practice out of network	70553	$3,507.00	—	Needs review	Needs review
CLM-2026-000027	2026-05-26	Evergreen Primary Care Associates in network	90471, 99395	$279.00	$155.00	Approved	Approved
CLM-2026-015376	2025-12-28	Valley Primary Care Associates in network	99395, 99214, 90471	$617.00	$342.54	Approved	Approved