Identities/MBR-012681

Gold, golden identity

Teresa Hayes

5 source records from 2 feeds.

MBR-012681Verified5 records

Golden record

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

First nameENR: Teresa
Middle name—: —
Last nameENR: Hayes
Date of birthENR: 1962-10-05
GenderENR: M
Member IDENR: UHC-81477-97
SSNENR: •••-••-3832
PhoneENR: 2623678546
EmailENR: teresa.hayes@yahoo.com
AddressENR: 2774 Pine Dr
CityENR: Gilbert
StateENR: AZ
ZIPCLM: 85236
GroupENR: GRP-5900
PlanENR: CHOICE-PLUS-PPO

Min confidence

0.97

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-403331	CLM	2026-02-13	Teresa Hayesflagged	1962-10-05	—	2623678546	2774 Pine Dr # 533, Gilbert, AZ	Scored	1.00	—
CLM-403332	CLM	2026-04-12	Teresa Hayesflagged	1962-10-05	—	2623678546	2774 Pine Dr, Gilbert, AZ	Scored	1.00	—
ENR-104333	ENR	2026-06-20	Teresa Hayesflagged	1962-10-05	UHC-81477-97	2623678546	2774 Pine Dr, Gilbert, AZ	Rule	0.97	D2 ssn4 + dob + last name
CLM-403330	CLM	2026-07-21	Teresa Hayesflagged	1962-10-05	—	—	2774 Pine Dr, Gilbert, AZ	Scored	1.00	—
CLM-403333	CLM	2026-08-22	Teresa Hayesflagged	1962-10-05	—	—	2774 Pine Dr, Gilbert, AZ	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-403331CLMCLM-403330CLM1.00Scoredweighted 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-403332CLMCLM-403330CLM1.00Scoredweighted 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-403331CLMCLM-403332CLM1.00Scoredweighted 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-403331CLMCLM-403333CLM1.00Scoredweighted 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-403330CLMCLM-403333CLM1.00Scoredweighted 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-403332CLMCLM-403333CLM0.97RuleD2 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
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶ENR-104333ENRCLM-403333CLM0.97RuleD2 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
Address	0.70	2	street_match

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-403332CLMENR-104333ENR0.97RuleD2 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
Address	0.70	2	street_match

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-403331CLMENR-104333ENR0.94Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	0.70	2	street_match

Identifiers agreeing: 2Conflicts: noneGuard: none

▶ENR-104333ENRCLM-403330CLM0.93Scoredweighted 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

Actions

What downstream consumers did with this identity

Eligibility conflict resolvedProposed
Teresa Hayes: 2 plan codes across sources → canonical CHOICE-PLUS-PPO
ACT-000574, Eligibility engine
Orphan claim re-pointedExecuted
CLM-403331 → UHC-81477-97 (Teresa Hayes)
ACT-002414, Claims processor
Orphan claim re-pointedExecuted
CLM-403330 → UHC-81477-97 (Teresa Hayes)
ACT-008036, Claims processor
Orphan claim re-pointedExecuted
CLM-403333 → UHC-81477-97 (Teresa Hayes)
ACT-008213, Claims processor
Orphan claim re-pointedExecuted
CLM-403332 → UHC-81477-97 (Teresa Hayes)
ACT-009547, Claims processor
Care coordination outreachProposed
Teresa Hayes: 4 claims, no attributed provider
ACT-018695, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallyf869f236c5
scoring_agent, CLM-403333, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:54:38Record linked automaticallyd725486c98
scoring_agent, CLM-403330, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:54:38Record linked automatically9b2dfac18f
matching_agent, ENR-104333, identity id MBR-012681, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record CLM-403332
2026-10-19 19:54:38Record linked automatically6e7708954c
scoring_agent, CLM-403332, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:54:38Record linked automaticallyfd37340e86
scoring_agent, CLM-403331, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403332, policy version 1
2026-10-19 19:52:09Record linked automatically8f47abb441
scoring_agent, CLM-403333, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:52:09Record linked automatically9e8ec21208
scoring_agent, CLM-403330, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:52:09Record linked automaticallyafecbd1a06
matching_agent, ENR-104333, identity id MBR-012681, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record CLM-403332
2026-10-19 19:52:09Record linked automaticallyf727ed956c
scoring_agent, CLM-403332, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:52:09Record linked automatically78c5030ac1
scoring_agent, CLM-403331, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403332, policy version 1
2026-10-19 19:45:42Record linked automatically07b3c45f06
scoring_agent, CLM-403333, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:45:42Record linked automaticallyc04fd3f655
scoring_agent, CLM-403330, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:45:42Record linked automatically123345beb3
matching_agent, ENR-104333, identity id MBR-012681, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record CLM-403332
2026-10-19 19:45:42Record linked automaticallyd8b4445c30
scoring_agent, CLM-403332, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:45:42Record linked automatically8525a2b0e0
scoring_agent, CLM-403331, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403332, policy version 1
2026-10-19 19:32:31Record linked automaticallye3adafe768
scoring_agent, CLM-403333, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:32:31Record linked automatically444eb727dd
scoring_agent, CLM-403330, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:32:31Record linked automaticallyfb58f280f1
matching_agent, ENR-104333, identity id MBR-012681, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record CLM-403332
2026-10-19 19:32:31Record linked automaticallybc80fcebb1
scoring_agent, CLM-403332, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403331, policy version 1
2026-10-19 19:32:31Record linked automaticallye16a9a5145
scoring_agent, CLM-403331, identity id MBR-012681, confidence 1, method probabilistic, matched record CLM-403332, policy version 1
2026-10-19 19:31:28Record linked automaticallybb3702332e
scoring_agent, CLM-403333, identity id MBR-029484, confidence 0.99, method probabilistic, matched record TPA-51500, policy version 1
2026-10-19 19:31:28Record linked automaticallyb3555c3645
scoring_agent, CLM-403332, identity id MBR-004649, confidence 1, method probabilistic, matched record CLM-403330, policy version 1
2026-10-19 19:31:28Record linked automatically1e9e0be5b1
scoring_agent, CLM-403331, identity id MBR-004649, confidence 1, method probabilistic, matched record CLM-403330, policy version 1
2026-10-19 19:31:28Record linked automatically9aca6c1354
scoring_agent, CLM-403330, identity id MBR-004649, confidence 1, method probabilistic, matched record PRV-21012, 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-2026-026049	2026-08-05	Riverside Orthopedic Specialists in network	29881	$8,330.00	$3,425.68	Approved	Approved
CLM-2026-025367	2026-07-01	Evergreen Dermatology Clinic in network	11403, 11102	$855.00	$490.10	Approved	Approved
CLM-2026-031277	2026-03-29	Evergreen Dermatology Clinic in network	17110	$203.00	$85.86	Approved	Approved
CLM-2026-004040	2026-02-09	Lakeside Medical Group in network	99213, 36415	$221.00	$117.02	Approved	Approved