Identities/MBR-004659
Gold, golden identity

Heather Ramirez

4 source records from 2 feeds.

MBR-004659Verified4 records

Golden record

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

First nameCLM
Heather
Middle name—
—
Last nameCLM
Ramirez
Date of birthCLM
1984-02-13
GenderCLM
F
Member IDCLM
UHC-38315-81
SSN—
—
PhoneCLM
7002360098
EmailCLM
heather.ramirez65@hotmail.com
AddressCLM
7274 Hillcrest Rd
CityCLM
Nashville
StateCLM
TN
ZIPCLM
37213
GroupTPA
GRP-5636
PlanCLM
NAVIGATE-HMO
Min confidence
0.99
Sources
CLM ×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

0.991.001.001.00CLMCLM-429787CLMCLM-429785CLMCLM-429786TPATPA-63150IDMBR-004659
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

RecordSourceReceivedNameDOBMember IDPhoneAddressMethodConfidenceRule
CLM-429787CLM2026-01-15Heather Ramirezflagged1984-02-13UHC-38315-81—7274 Hillcrest Rd, Nashville, TNRule0.99D1 member id + dob exact
CLM-429785CLM2026-02-19Heather Ramirezflagged1984-02-13UHC-38315-8170023600987274 Hillcrest Rd, Nashville, TNScored1.00—
CLM-429786CLM2026-05-02Heather Ramirezflagged1984-02-13—7002360098—Scored1.00—
TPA-63150TPA2026-09-08Heather Ramirezflagged1984-02-13———Scored1.00—

Evidence

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

ABScoreMethodRuleDecision
▶CLM-429785CLMCLM-429786CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-429786CLMTPA-63150 TPA1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Email1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-429787CLMCLM-429785CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-429787CLMCLM-429786CLM0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees
▶CLM-429787CLMTPA-63150 TPA0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees
▶CLM-429785CLMTPA-63150 TPA0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

Actions

What downstream consumers did with this identity

  • Orphan claim re-pointedExecuted
    CLM-429786 → UHC-38315-81 (Heather Ramirez)
    ACT-001468, Claims processor
  • Care coordination outreachProposed
    Heather Ramirez: 3 claims, no attributed provider
    ACT-018139, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-19 19:54:38Record linked automatically589dfa1807
    scoring_agent, TPA-63150, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallyefb2b6dac9
    scoring_agent, CLM-429786, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429785, policy version 1
  • 2026-10-19 19:54:38Record linked automatically7aa580f3b4
    scoring_agent, CLM-429785, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallydacea59117
    matching_agent, CLM-429787, identity id MBR-004659, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429785
  • 2026-10-19 19:52:08Record linked automatically21b93147a5
    scoring_agent, TPA-63150, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:52:08Record linked automatically86109a330d
    scoring_agent, CLM-429786, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429785, policy version 1
  • 2026-10-19 19:52:08Record linked automatically0e145e41b0
    scoring_agent, CLM-429785, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:52:08Record linked automaticallyaf1c110230
    matching_agent, CLM-429787, identity id MBR-004659, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429785
  • 2026-10-19 19:45:42Record linked automatically6b0ddf2700
    scoring_agent, TPA-63150, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:45:42Record linked automatically1a94acf0a3
    scoring_agent, CLM-429786, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429785, policy version 1
  • 2026-10-19 19:45:42Record linked automatically617be938a1
    scoring_agent, CLM-429785, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:45:42Record linked automatically6d5afaaad2
    matching_agent, CLM-429787, identity id MBR-004659, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429785
  • 2026-10-19 19:32:31Record linked automatically524a0025ee
    scoring_agent, TPA-63150, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:32:31Record linked automatically5cc4219d26
    scoring_agent, CLM-429786, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429785, policy version 1
  • 2026-10-19 19:32:31Record linked automatically59509e39ea
    scoring_agent, CLM-429785, identity id MBR-004659, confidence 1, method probabilistic, matched record CLM-429786, policy version 1
  • 2026-10-19 19:32:31Record linked automaticallyd766367f26
    matching_agent, CLM-429787, identity id MBR-004659, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429785
  • 2026-10-19 19:31:28Record linked automaticallybce95e54ae
    scoring_agent, CLM-429785, identity id MBR-034959, confidence 1, method probabilistic, matched record PRV-28744, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallye60985919a
    matching_agent, TPA-63150, identity id MBR-022025, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-63152
  • 2026-10-19 19:31:28Record linked automatically21fa5fd259
    matching_agent, CLM-429786, identity id MBR-014932, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-139341
  • 2026-10-19 19:31:28Record linked automaticallyf0171ecc0f
    matching_agent, CLM-429787, identity id MBR-006829, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-139343

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0006002026-04-07Summit Imaging Center
in network
77067, 71046, 76700$908.00$0.00ApprovedApproved
CLM-2026-0169582026-02-10Evergreen Family Practice
in network
99213, 99395$523.00$304.26ApprovedApproved
CLM-2026-0023732025-12-25Mesa Physical Therapy
in network
97110$128.00$59.36ApprovedApproved