Identities/MBR-005611

Gold, golden identity

Karen Q Ruiz

6 source records from 3 feeds.

MBR-005611Verified6 records

Golden record

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

First nameENR: Karen
Middle nameCLM: Q
Last nameENR: Ruiz
Date of birthENR: 1943-08-01
GenderENR: F
Member IDENR: UHC-25421-25
SSNENR: •••-••-1734
PhoneENR: 9193230121
EmailENR: karen.ruiz98@outlook.com
AddressENR: 5995 Sage Ct
CityENR: Austin
StateENR: TX
ZIPENR: 78782
GroupENR: GRP-6459
PlanENR: MEDICARE-ADV-B

Min confidence

1.00

Sources

CLM ×3ENR ×1TPA ×2

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-420233	CLM	2026-01-18	Karen Ruizflagged	1943-08-01	UHC-25421-25	9193230121	5995 Sage Ct, Austin, TX	Scored	1.00	—
CLM-420234	CLM	2026-04-18	Karen Ruizflagged	1943-08-01	—	9193230121	5995 Sage Ct, Austin, TX	Scored	1.00	—
ENR-126600	ENR	2026-06-27	Karen Ruizflagged	1943-08-01	UHC-25421-25	9193230121	5995 Sage Ct, Austin, TX	Scored	1.00	—
TPA-58905	TPA	2026-07-06	Karen Ruizflagged	1943-08-01	UHC-25421-25	—	5995 Sage Ct, Austin, TX	Scored	1.00	—
TPA-58904	TPA	2026-08-10	Karen Ruizflagged	1943-08-01	—	—	5995 Sage Ct, Austin, TX	Scored	1.00	—
CLM-420235	CLM	2026-09-24	Karen Ruizflagged	1943-08-01	—	—	5995 Sage Ct, Austin, TX	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-420233CLMCLM-420234CLM1.00Scoredweighted 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-420233CLMCLM-420235CLM1.00Scoredweighted 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

▶CLM-420234CLMCLM-420235CLM1.00Scoredweighted 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

▶ENR-126600ENRCLM-420235CLM1.00Scoredweighted 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

▶TPA-58905TPACLM-420235CLM1.00Scoredweighted 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

▶TPA-58904TPACLM-420235CLM1.00Scoredweighted 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

▶CLM-420233CLMTPA-58904TPA1.00Scoredweighted 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

▶CLM-420234CLMTPA-58904TPA1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶ENR-126600ENRTPA-58904TPA1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-58905TPATPA-58904TPA1.00Scoredweighted 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

▶CLM-420234CLMTPA-58905TPA1.00Scoredweighted 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

▶CLM-420233CLMENR-126600ENR0.99RuleD1 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-420233CLMTPA-58905TPA0.99RuleD1 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

▶ENR-126600ENRTPA-58905TPA0.99RuleD1 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-420234CLMENR-126600ENR0.97RuleD2 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
Email	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 4Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-420234 → UHC-25421-25 (Karen Ruiz)
ACT-009539, Claims processor
Orphan claim re-pointedExecuted
CLM-420235 → UHC-25421-25 (Karen Ruiz)
ACT-010332, Claims processor
Care coordination outreachProposed
Karen Ruiz: 3 claims, no attributed provider
ACT-018218, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallyb0dbfd8f8d
scoring_agent, CLM-420235, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:54:38Record linked automatically2014e17dd1
scoring_agent, TPA-58904, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:54:38Record linked automaticallya91b133bad
scoring_agent, TPA-58905, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:54:38Record linked automaticallybc081b55b6
scoring_agent, ENR-126600, identity id MBR-005611, confidence 1, method probabilistic, matched record TPA-58904, policy version 1
2026-10-19 19:54:38Record linked automaticallydff64d2cdb
scoring_agent, CLM-420234, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:54:38Record linked automatically0b0630f715
scoring_agent, CLM-420233, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:52:08Record linked automatically4caf3dfd15
scoring_agent, CLM-420235, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:52:08Record linked automatically213beadb87
scoring_agent, TPA-58904, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:52:08Record linked automatically7d16fed730
scoring_agent, TPA-58905, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:52:08Record linked automatically372f97f8d0
scoring_agent, ENR-126600, identity id MBR-005611, confidence 1, method probabilistic, matched record TPA-58904, policy version 1
2026-10-19 19:52:08Record linked automatically40a00758da
scoring_agent, CLM-420234, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:52:08Record linked automaticallyf0abbc19b8
scoring_agent, CLM-420233, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:45:42Record linked automatically580877a0dc
scoring_agent, CLM-420235, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:45:42Record linked automatically29419a6a2f
scoring_agent, TPA-58904, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:45:42Record linked automatically99ea9fc1dd
scoring_agent, TPA-58905, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:45:42Record linked automaticallyc5aa51310b
scoring_agent, ENR-126600, identity id MBR-005611, confidence 1, method probabilistic, matched record TPA-58904, policy version 1
2026-10-19 19:45:42Record linked automatically66f2fda788
scoring_agent, CLM-420234, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:45:42Record linked automaticallyc65b469291
scoring_agent, CLM-420233, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:32:31Record linked automatically65f2e4cc5f
scoring_agent, CLM-420235, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:32:31Record linked automaticallyf0d3defc31
scoring_agent, TPA-58904, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:32:31Record linked automaticallyf63048d6b9
scoring_agent, TPA-58905, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:32:31Record linked automaticallyd729b68231
scoring_agent, ENR-126600, identity id MBR-005611, confidence 1, method probabilistic, matched record TPA-58904, policy version 1
2026-10-19 19:32:31Record linked automatically9ad39a09f6
scoring_agent, CLM-420234, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420233, policy version 1
2026-10-19 19:32:31Record linked automatically7a7a995f94
scoring_agent, CLM-420233, identity id MBR-005611, confidence 1, method probabilistic, matched record CLM-420234, policy version 1
2026-10-19 19:31:28Record linked automatically25ac4723e3
matching_agent, CLM-420233, identity id MBR-015119, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-126553
2026-10-19 19:31:28Record linked automatically15491664db
matching_agent, CLM-420235, identity id MBR-008949, confidence 0.96, rule D3 member_id + name, method deterministic, matched record ENR-126563
2026-10-19 19:31:28Record linked automaticallya3425724e8
scoring_agent, TPA-58904, identity id MBR-007617, confidence 0.95, method probabilistic, matched record TPA-58903, policy version 1
2026-10-19 19:31:28Record linked automaticallyc10e610778
scoring_agent, TPA-58905, identity id MBR-005509, confidence 1, method probabilistic, matched record ENR-126786, policy version 1
2026-10-19 19:31:28Record linked automatically27f48ac227
matching_agent, CLM-420234, identity id MBR-005185, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-126560
2026-10-19 19:31:28Record linked automatically6cf991766e
matching_agent, ENR-126600, identity id MBR-002801, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-420271

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-2026-034216	2026-08-16	Evergreen Cardiovascular Associates in network	93015, 93458	$7,470.00	$2,254.79	Approved	Approved
CLM-2026-031260	2026-04-07	Mesa Internal Medicine Associates out of network	99215	$354.00	$139.30	Approved	Approved
CLM-2026-002455	2025-12-04	Harbor Endocrine Associates in network	83036, 99214	$337.00	$179.80	Approved	Approved