Identities/MBR-015346

Gold, golden identity

Abigail R Rios

6 source records from 2 feeds.

MBR-015346Verified6 records

Golden record

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

First nameCLM: Abigail
Middle nameCLM: R
Last nameCLM: Rios
Date of birthCLM: 1979-05-26
GenderCLM: M
Member IDCLM: UHC-06532-92
SSNCLM: •••-••-9314
PhoneCLM: 7957894652
EmailTPA: abigail.rios62@outlook.com
AddressCLM: 5815 Bayshore Dr
CityCLM: San Antonio
StateCLM: TX
ZIPCLM: 78296
GroupCLM: GRP-8666
PlanCLM: SELECT-EPO

Min confidence

0.93

Sources

CLM ×5TPA ×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-427983	CLM	2026-02-23	Abigail Riosflagged	1979-05-26	—	—	5815 Bayshore Dr, San Antonio, TX	Scored	1.00	—
CLM-427981	CLM	2026-03-10	Abigail Riosflagged	1979-05-26	UHC-06532-92	—	5815 Bayshore Dr # 723, San Antonio, TX	Scored	1.00	—
TPA-62358	TPA	2026-04-25	Abigail Riosflagged	1979-05-26	—	—	5815 Bayshore Dr, San Antonio, TX	Scored	0.93	—
CLM-427979	CLM	2026-05-03	Abigail Riosflagged	1979-05-26	UHC-06532-92	7957894652	5815 Bayshore Dr, San Antonio, TX	Scored	1.00	—
CLM-427980	CLM	2026-06-30	Abigail Riosflagged	—	UHC-06532-92	—	5815 Bayshore Dr # 218, San Antonio, TX	Rule	0.96	D3 member id + name
CLM-427982	CLM	2026-07-21	Abigail Riosflagged	1979-05-26	—	7957894652	5815 Bayshore Dr, San Antonio, TX	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-427983CLMCLM-427979CLM1.00Scoredweighted 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-427983CLMCLM-427981CLM1.00Scoredweighted 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-427983CLMCLM-427982CLM1.00Scoredweighted 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-427981CLMCLM-427982CLM1.00Scoredweighted 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-427979CLMCLM-427982CLM1.00Scoredweighted 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-427981CLMCLM-427979CLM0.99RuleD1 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-427981CLMCLM-427980CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
SSN (last four)	1.00	2.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-427979CLMCLM-427980CLM0.96RuleD3 member id + nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Member ID	1.00	4
SSN (last four)	1.00	2.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

▶TPA-62358TPACLM-427979CLM0.93Scoredweighted 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-62358TPACLM-427982CLM0.93Scoredweighted 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-427983CLMTPA-62358TPA0.93Scoredweighted 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-427981CLMTPA-62358TPA0.93Scoredweighted 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-427983CLMCLM-427980CLM0.83Scoredweighted 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

▶CLM-427980CLMCLM-427982CLM0.83Scoredweighted 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-427983 → UHC-06532-92 (Abigail Rios)
ACT-003587, Claims processor
Orphan claim re-pointedExecuted
CLM-427982 → UHC-06532-92 (Abigail Rios)
ACT-007559, Claims processor
Care coordination outreachProposed
Abigail Rios: 5 claims, no attributed provider
ACT-018848, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automatically9f96367e06
scoring_agent, CLM-427982, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:54:38Record linked automatically571003a98f
matching_agent, CLM-427980, identity id MBR-015346, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-427981
2026-10-19 19:54:38Record linked automatically4e057127ee
scoring_agent, CLM-427979, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:54:38Record linked automaticallyfd3a124f02
scoring_agent, TPA-62358, identity id MBR-015346, confidence 0.93, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:54:38Record linked automatically0e4c0022f0
scoring_agent, CLM-427981, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:54:38Record linked automaticallyf3be4812a9
scoring_agent, CLM-427983, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427981, policy version 1
2026-10-19 19:52:09Record linked automatically6c7db1813f
scoring_agent, CLM-427982, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:52:09Record linked automaticallyc350a1d437
matching_agent, CLM-427980, identity id MBR-015346, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-427981
2026-10-19 19:52:09Record linked automatically1f9d2f0786
scoring_agent, CLM-427979, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:52:09Record linked automatically000f2d571e
scoring_agent, TPA-62358, identity id MBR-015346, confidence 0.93, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:52:09Record linked automatically5989d06ca0
scoring_agent, CLM-427981, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:52:09Record linked automatically6ff69adee6
scoring_agent, CLM-427983, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427981, policy version 1
2026-10-19 19:45:42Record linked automatically820ba40dbf
scoring_agent, CLM-427982, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:45:42Record linked automatically3eb7933e2e
matching_agent, CLM-427980, identity id MBR-015346, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-427981
2026-10-19 19:45:42Record linked automaticallydebc26e951
scoring_agent, CLM-427979, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:45:42Record linked automatically63d44be05a
scoring_agent, TPA-62358, identity id MBR-015346, confidence 0.93, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:45:42Record linked automatically04fc2eb567
scoring_agent, CLM-427981, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:45:42Record linked automaticallyb64a80f9a0
scoring_agent, CLM-427983, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427981, policy version 1
2026-10-19 19:32:31Record linked automatically7d3614e2f9
scoring_agent, CLM-427982, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:32:31Record linked automatically90533016c8
matching_agent, CLM-427980, identity id MBR-015346, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-427981
2026-10-19 19:32:31Record linked automaticallyd895aa9df8
scoring_agent, CLM-427979, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:32:31Record linked automatically8f2abd5b44
scoring_agent, TPA-62358, identity id MBR-015346, confidence 0.93, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:32:31Record linked automaticallyc7b27854a5
scoring_agent, CLM-427981, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427983, policy version 1
2026-10-19 19:32:31Record linked automatically568f0bffc1
scoring_agent, CLM-427983, identity id MBR-015346, confidence 1, method probabilistic, matched record CLM-427981, policy version 1
2026-10-19 19:31:28Record linked automatically2a6817ca24
matching_agent, CLM-427982, identity id MBR-040043, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-137003
2026-10-19 19:31:28Record linked automatically260d3f592b
matching_agent, CLM-427983, identity id MBR-040043, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-137003
2026-10-19 19:31:28Record linked automatically07e6ec6636
scoring_agent, CLM-427980, identity id MBR-012500, confidence 1, method probabilistic, matched record CLM-427979, policy version 1
2026-10-19 19:31:28Record linked automatically258bfdb02c
scoring_agent, CLM-427979, identity id MBR-012500, confidence 1, method probabilistic, matched record CLM-427980, 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-2026-023552	2026-07-15	Evergreen Rehabilitation Center in network	97110	$288.00	—	Denied	Denied
CLM-2026-017273	2026-06-28	Lakeside Physical Therapy in network	97110	$228.00	—	Denied	Denied
CLM-2026-023207	2026-04-07	Harbor Primary Care Associates in network	99213	$194.00	$95.28	Approved	Approved
CLM-2026-001688	2026-02-27	Riverside Family Practice in network	99395	$322.00	$174.64	Approved	Approved
CLM-2026-008498	2026-02-16	Northgate Clinical Laboratories in network	85025	$55.00	$0.00	Approved	Approved