Identities/MBR-011970

Gold, golden identity

Carol L Kelly

5 source records from 3 feeds.

MBR-011970Verified5 records

Golden record

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

First nameENR: Carol
Middle nameTPA: L
Last nameENR: Kelly
Date of birthCLM: 1939-10-17
GenderENR: F
Member IDENR: UHC-09522-48
SSNENR: •••-••-2022
PhoneENR: 3018346050
EmailENR: carol.kelly63@icloud.com
AddressCLM: 1796 Maple Ave # 529
CityENR: Seattle
StateENR: WA
ZIPENR: 98114
GroupENR: GRP-1837
PlanENR: CORE-HMO

Min confidence

0.99

Sources

CLM ×3TPA ×1ENR ×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-418345	CLM	2026-02-10	Carol Kellyflagged	1939-10-17	UHC-09522-48	3018346050	—	Scored	1.00	—
CLM-418343	CLM	2026-02-25	Carol Kellyflagged	1939-10-17	UHC-09522-48	—	1796 Maple Ave, Seattle, WA	Rule	0.99	D1 member id + dob exact
TPA-58083	TPA	2026-03-16	Carol Kellyflagged	1939-10-17	—	3018346050	1796 Maple Ave, Seattle, WA	Scored	1.00	—
ENR-124123	ENR	2026-06-12	Carol Kellyflagged	—	UHC-09522-48	3018346050	1796 Maple Ave, Seattle, WA	Scored	1.00	—
CLM-418344	CLM	2026-07-24	Carol Kellyflagged	1939-10-17	—	—	1796 Maple Ave # 529, Seattle, WA	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶TPA-58083TPACLM-418344CLM1.00Scoredweighted 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-58083TPAENR-124123ENR1.00Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-418345CLMTPA-58083TPA1.00Scoredweighted 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-418345CLMCLM-418343CLM0.99RuleD1 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
Email	1.00	1.5

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-418345CLMENR-124123ENR0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight
Name	1.00	3
Member ID	1.00	4
Phone	1.00	1.5
Email	1.00	1.5

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-418343CLMENR-124123ENR0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
Email	1.00	1.5
Address	0.70	2	street_match

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-418343CLMCLM-418344CLM0.93Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	0.70	2	street_match

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-418343CLMTPA-58083TPA0.93Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Address	0.70	2	street_match

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-418345CLMCLM-418344CLM0.83Scoredweighted 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

▶ENR-124123ENRCLM-418344CLM0.83Scoredweighted similaritySent to steward

Field	Similarity	Weight	Note
Name	1.00	3
Address	1.00	2	exact

Identifiers agreeing: 1Conflicts: noneGuard: Too few fields to compare

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-418344 → UHC-09522-48 (Carol Kelly)
ACT-005235, Claims processor
Outreach address correctedProposed
Carol Kelly: 1796 Maple Ave, Seattle → 1796 Maple Ave # 529, Seattle
ACT-011594, Outreach
Care coordination outreachProposed
Carol Kelly: 3 claims, no attributed provider
ACT-018649, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automatically30589db257
scoring_agent, CLM-418344, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:54:38Record linked automatically4d768b52a6
scoring_agent, ENR-124123, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:54:38Record linked automaticallyc20e393268
scoring_agent, TPA-58083, identity id MBR-011970, confidence 1, method probabilistic, matched record CLM-418345, policy version 1
2026-10-19 19:54:38Record linked automatically7956a39f17
matching_agent, CLM-418343, identity id MBR-011970, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-418345
2026-10-19 19:54:38Record linked automatically13ec5568a3
scoring_agent, CLM-418345, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:52:09Record linked automatically188895b344
scoring_agent, CLM-418344, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:52:09Record linked automaticallyed5b711c46
scoring_agent, ENR-124123, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:52:09Record linked automatically881a2b6d85
scoring_agent, TPA-58083, identity id MBR-011970, confidence 1, method probabilistic, matched record CLM-418345, policy version 1
2026-10-19 19:52:09Record linked automatically921716836d
matching_agent, CLM-418343, identity id MBR-011970, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-418345
2026-10-19 19:52:09Record linked automatically897ba3b8c6
scoring_agent, CLM-418345, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:45:42Record linked automatically9fe8b738f0
scoring_agent, CLM-418344, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:45:42Record linked automatically91f4f11908
scoring_agent, ENR-124123, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:45:42Record linked automatically7f493c66de
scoring_agent, TPA-58083, identity id MBR-011970, confidence 1, method probabilistic, matched record CLM-418345, policy version 1
2026-10-19 19:45:42Record linked automaticallyef9776bffd
matching_agent, CLM-418343, identity id MBR-011970, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-418345
2026-10-19 19:45:42Record linked automaticallye3ced975f5
scoring_agent, CLM-418345, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:32:31Record linked automatically13ba3d01ed
scoring_agent, CLM-418344, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:32:31Record linked automaticallycdab088175
scoring_agent, ENR-124123, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:32:31Record linked automaticallye33fb781b2
scoring_agent, TPA-58083, identity id MBR-011970, confidence 1, method probabilistic, matched record CLM-418345, policy version 1
2026-10-19 19:32:31Record linked automaticallycfc6c26d24
matching_agent, CLM-418343, identity id MBR-011970, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-418345
2026-10-19 19:32:31Record linked automatically611f1041f3
scoring_agent, CLM-418345, identity id MBR-011970, confidence 1, method probabilistic, matched record TPA-58083, policy version 1
2026-10-19 19:31:28Record linked automatically7e33766241
matching_agent, TPA-58083, identity id MBR-015922, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-58082
2026-10-19 19:31:28Record linked automatically3ae19de099
matching_agent, CLM-418345, identity id MBR-015509, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-418346
2026-10-19 19:31:28Record linked automatically6970b73c16
matching_agent, ENR-124123, identity id MBR-014013, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record PRV-25379
2026-10-19 19:31:28Record linked automaticallycf6151f288
scoring_agent, CLM-418344, identity id MBR-010947, confidence 0.99, method probabilistic, matched record ENR-124003, policy version 1
2026-10-19 19:31:28Record linked automatically15b66d32cf
matching_agent, CLM-418343, identity id MBR-010947, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-124003

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-2026-014769	2026-07-11	Northgate Internal Medicine Associates in network	80053	$65.00	$20.30	Approved	Approved
CLM-2026-021133	2026-02-10	Mesa Physical Therapy in network	97110, 97161	$531.00	$309.22	Approved	Approved
CLM-2026-011091	2026-01-16	Riverside Cardiovascular Associates in network	93306, 93458	$8,535.00	—	Needs review	Needs review