Identities/MBR-013631

Gold, golden identity

Kathleen Cruz

5 source records from 3 feeds.

MBR-013631Verified5 records

Golden record

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

First nameCLM: Kathleen
Middle name—: —
Last nameENR: Cruz
Date of birthENR: 1967-10-10
GenderENR: F
Member IDENR: UHC-59287-85
SSNENR: •••-••-9820
PhoneCLM: 8084329601
EmailENR: kathleen.cruz@hotmail.com
AddressCLM: 9570 Church St
CityENR: San Diego
StateENR: CA
ZIPENR: 92175
GroupENR: GRP-0933
PlanENR: MEDICARE-ADV-B

Min confidence

0.97

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-404348	CLM	2026-02-16	Kathleen Cruzflagged	1967-10-10	UHC-59287-85	—	9570 Church St, San Diego, CA	Scored	1.00	—
TPA-51895	TPA	2026-03-22	Kathleen Cruzflagged	1967-10-10	—	—	9570 Church St, San Diego, CA	Rule	0.97	D2 ssn4 + dob + last name
ENR-105729	ENR	2026-04-25	Kathy Cruzflagged	1967-10-10	UHC-59287-85	—	9570 Church St Apt 14, San Diego, CA	Scored	1.00	—
CLM-404350	CLM	2026-07-20	Kathy Cruzflagged	1967-10-10	—	8084329601	9570 Church St, San Diego, CA	Scored	1.00	—
CLM-404349	CLM	2026-08-08	Kathleen Cruzflagged	1967-10-10	—	8084329601	9570 Church St, San Diego, CA	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-404348CLMCLM-404349CLM1.00Scoredweighted 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-105729ENRCLM-404349CLM1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-404350CLMCLM-404349CLM1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-404348CLMCLM-404350CLM1.00Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶ENR-105729ENRCLM-404350CLM1.00Scoredweighted 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-404348CLMENR-105729ENR0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3	nickname
Date of birth	1.00	3	exact
Member ID	1.00	4
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-51895 TPAENR-105729ENR0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3	nickname
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

▶TPA-51895 TPACLM-404349CLM0.93Scoredweighted 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

▶TPA-51895 TPACLM-404350CLM0.93Scoredweighted similarityAuto-linked

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

Identifiers agreeing: 1Conflicts: noneGuard: none

▶CLM-404348CLMTPA-51895 TPA0.93Scoredweighted 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

Orphan claim re-pointedExecuted
CLM-404349 → UHC-59287-85 (Kathleen Cruz)
ACT-002840, Claims processor
Orphan claim re-pointedExecuted
CLM-404350 → UHC-59287-85 (Kathleen Cruz)
ACT-003092, Claims processor
Outreach address correctedProposed
Kathleen Cruz: 9570 Church St Apt 14, San Diego → 9570 Church St, San Diego
ACT-011731, Outreach
Care coordination outreachProposed
Kathleen Cruz: 3 claims, no attributed provider
ACT-018750, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automaticallye462f4c717
scoring_agent, CLM-404349, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:54:38Record linked automatically46c8dde648
scoring_agent, CLM-404350, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:54:38Record linked automatically52a508a163
scoring_agent, ENR-105729, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:54:38Record linked automatically88826bdef8
matching_agent, TPA-51895, identity id MBR-013631, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-105729
2026-10-19 19:54:38Record linked automatically2d8c7dcb31
scoring_agent, CLM-404348, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:52:09Record linked automatically3b19ae5731
scoring_agent, CLM-404349, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:52:09Record linked automatically829b199474
scoring_agent, CLM-404350, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:52:09Record linked automaticallyc403cbcc98
scoring_agent, ENR-105729, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:52:09Record linked automaticallyd4ae3c7410
matching_agent, TPA-51895, identity id MBR-013631, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-105729
2026-10-19 19:52:09Record linked automatically719f5f4602
scoring_agent, CLM-404348, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:45:42Record linked automatically31d099f0cf
scoring_agent, CLM-404349, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:45:42Record linked automatically19b8a272e8
scoring_agent, CLM-404350, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:45:42Record linked automatically6941554737
scoring_agent, ENR-105729, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:45:42Record linked automaticallyc5c97c0d7c
matching_agent, TPA-51895, identity id MBR-013631, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-105729
2026-10-19 19:45:42Record linked automatically3092091656
scoring_agent, CLM-404348, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:32:31Record linked automaticallyd22cf82561
scoring_agent, CLM-404349, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:32:31Record linked automatically66eb466162
scoring_agent, CLM-404350, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404348, policy version 1
2026-10-19 19:32:31Record linked automaticallyaa6a6dfafa
scoring_agent, ENR-105729, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:32:31Record linked automatically269df9199b
matching_agent, TPA-51895, identity id MBR-013631, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-105729
2026-10-19 19:32:31Record linked automatically44e1d06f26
scoring_agent, CLM-404348, identity id MBR-013631, confidence 1, method probabilistic, matched record CLM-404350, policy version 1
2026-10-19 19:31:28Record linked automatically4fa37f93d6
scoring_agent, TPA-51895, identity id MBR-026926, confidence 1, method probabilistic, matched record PRV-21261, policy version 1
2026-10-19 19:31:28Record linked automatically9d959b5a84
scoring_agent, ENR-105729, identity id MBR-024129, confidence 1, method probabilistic, matched record TPA-51965, policy version 1
2026-10-19 19:31:28Record linked automatically174073962b
matching_agent, CLM-404349, identity id MBR-001176, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-105663

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-2026-005694	2026-06-29	Northgate Orthopedic Specialists in network	27447	$29,657.00	—	Needs review	Needs review
CLM-2026-005693	2026-06-29	Valley Bone and Joint Center out of network	27447	$29,657.00	—	Needs review	Needs review
CLM-2026-006683	2026-06-05	Unity Medical Group in network	99232	$258.00	$0.00	Approved	Approved
CLM-2026-018004	2026-01-26	Lakeside Skin Care Associates in network	11102, 17110, 11403	$977.00	$545.74	Approved	Approved