Identities/MBR-010963

Gold, golden identity

Betty Rojas

6 source records from 2 feeds.

MBR-010963Verified6 records

Golden record

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

First nameENR: Betty
Middle name—: —
Last nameENR: Rojas
Date of birthENR: 1976-12-27
GenderENR: F
Member IDENR: UHC-59588-79
SSNENR: •••-••-1910
PhoneENR: 2533774468
EmailCLM: betty.rojas@yahoo.com
AddressCLM: 3322 Hillcrest Rd
CityCLM: Sacramento
StateCLM: CA
ZIPCLM: 95831
GroupENR: GRP-2268
PlanENR: CORE-HMO

Min confidence

0.98

Sources

CLM ×5ENR ×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-411317	CLM	2026-02-06	Betty Rojasflagged	1976-12-27	—	2533774468	3322 Hillcrest Rd, Sacramento, CA	Scored	1.00	—
CLM-411318	CLM	2026-02-09	Rojas Bttyflagged	1976-12-27	—	2533774468	3322 Hillcrest Rd, Sacramento, CA	Scored	0.98	—
CLM-411316	CLM	2026-05-03	Betty Rojasflagged	1976-12-27	UHC-59588-79	2533774468	3322 Hillcrest Rd, Sacramento, CA	Scored	1.00	—
CLM-411319	CLM	2026-07-07	Betty Rojasflagged	1976-12-27	UHC-59588-79	—	3322 Hillcrest Rd, Sacramento, CA	Scored	1.00	—
ENR-114891	ENR	2026-08-10	Betty Rojasflagged	1976-12-27	UHC-59588-79	2533774468	—	Scored	1.00	—
CLM-411320	CLM	2026-10-11	Betty Rojasflagged	1976-12-27	UHC-59588-79	—	—	Rule	0.99	D1 member id + dob exact

Evidence

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

Score

Method

Rule

Decision

▶CLM-411317CLMCLM-411316 CLM1.00Scoredweighted 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-411317CLMCLM-411319CLM1.00Scoredweighted 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-411317CLMENR-114891ENR1.00Scoredweighted 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-411316 CLMCLM-411319CLM0.99RuleD1 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
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-411316 CLMCLM-411320CLM0.99RuleD1 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-411319CLMCLM-411320CLM0.99RuleD1 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-114891ENRCLM-411320CLM0.99RuleD1 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-411316 CLMENR-114891ENR0.99RuleD1 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

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-411319CLMENR-114891ENR0.99RuleD1 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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-411317CLMCLM-411318CLM0.98Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.93	3	swapped
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-411318CLMCLM-411316 CLM0.97Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.92	3	swapped
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-411318CLMENR-114891ENR0.97Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	0.92	3	swapped
Date of birth	1.00	3	exact
Phone	1.00	1.5

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-411317CLMCLM-411320CLM0.83Scoredweighted 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

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-411318 → UHC-59588-79 (Betty Rojas)
ACT-001623, Claims processor
Orphan claim re-pointedExecuted
CLM-411317 → UHC-59588-79 (Betty Rojas)
ACT-008173, Claims processor
Care coordination outreachProposed
Betty Rojas: 5 claims, no attributed provider
ACT-018586, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallyf8d7de59f6
matching_agent, CLM-411320, identity id MBR-010963, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-411316
2026-10-19 19:54:38Record linked automatically3e241c2e95
scoring_agent, ENR-114891, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:54:38Record linked automatically3b8a9c0d38
scoring_agent, CLM-411319, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:54:38Record linked automatically6d0bc25601
scoring_agent, CLM-411316, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:54:38Record linked automaticallycfba696b42
scoring_agent, CLM-411318, identity id MBR-010963, confidence 0.98, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:54:38Record linked automatically5fd58eca48
scoring_agent, CLM-411317, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411316, policy version 1
2026-10-19 19:52:09Record linked automaticallya8657d1af9
matching_agent, CLM-411320, identity id MBR-010963, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-411316
2026-10-19 19:52:09Record linked automaticallyf0c73a00d3
scoring_agent, ENR-114891, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:52:09Record linked automaticallydb913a2485
scoring_agent, CLM-411319, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:52:09Record linked automaticallyb4cbc8a3c5
scoring_agent, CLM-411316, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:52:09Record linked automatically4e9abbe122
scoring_agent, CLM-411318, identity id MBR-010963, confidence 0.98, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:52:09Record linked automaticallyaa7844be96
scoring_agent, CLM-411317, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411316, policy version 1
2026-10-19 19:45:42Record linked automatically20e72025ee
matching_agent, CLM-411320, identity id MBR-010963, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-411316
2026-10-19 19:45:42Record linked automatically06c3f6b012
scoring_agent, ENR-114891, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:45:42Record linked automaticallyc6459f1954
scoring_agent, CLM-411319, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:45:42Record linked automaticallya7026f91b4
scoring_agent, CLM-411316, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:45:42Record linked automatically1881678323
scoring_agent, CLM-411318, identity id MBR-010963, confidence 0.98, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:45:42Record linked automatically87b8f45ffd
scoring_agent, CLM-411317, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411316, policy version 1
2026-10-19 19:32:31Record linked automaticallya7ea06ba8b
matching_agent, CLM-411320, identity id MBR-010963, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-411316
2026-10-19 19:32:31Record linked automatically1a6e3a6228
scoring_agent, ENR-114891, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:32:31Record linked automatically142961dfe7
scoring_agent, CLM-411319, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:32:31Record linked automaticallyed9f0afd9c
scoring_agent, CLM-411316, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:32:31Record linked automatically2ebeadbc6e
scoring_agent, CLM-411318, identity id MBR-010963, confidence 0.98, method probabilistic, matched record CLM-411317, policy version 1
2026-10-19 19:32:31Record linked automatically7f42d7c6d7
scoring_agent, CLM-411317, identity id MBR-010963, confidence 1, method probabilistic, matched record CLM-411316, policy version 1
2026-10-19 19:31:28Record linked automatically67937912d5
scoring_agent, CLM-411316, identity id MBR-036457, confidence 1, method probabilistic, matched record CLM-411315, policy version 1
2026-10-19 19:31:28Record linked automatically959373610e
scoring_agent, CLM-411320, identity id MBR-025362, confidence 0.99, method probabilistic, matched record ENR-114975, policy version 1
2026-10-19 19:31:28Record linked automatically30ccaf3379
scoring_agent, CLM-411319, identity id MBR-005558, confidence 1, method probabilistic, matched record TPA-55014, policy version 1
2026-10-19 19:31:28Record linked automatically00ff1c8182
matching_agent, CLM-411317, identity id MBR-001277, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-114973
2026-10-19 19:31:28Record linked automaticallyc352cf9588
scoring_agent, CLM-411318, identity id MBR-001277, confidence 1, method probabilistic, matched record ENR-114973, 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-2026-002248	2026-09-09	Northgate Internal Medicine Associates in network	80053, 99215	$474.00	$253.88	Approved	Approved
CLM-2026-030442	2026-05-28	Unity Primary Care Associates in network	99203	$260.00	$121.20	Approved	Approved
CLM-2026-011205	2026-01-10	Canyon Internal Medicine Associates out of network	99232	$242.00	—	Denied	Denied
CLM-2026-001174	2025-12-30	Riverside GI Associates in network	45378, 43239	$2,992.00	$841.98	Approved	Approved
CLM-2026-025926	2026-02-04	Desert Medical Group in network	99203, 36415	$251.00	$115.62	Approved	Approved