Gold, golden identity
Aisha Rojas
3 source records from 1 feed.
Golden record
Source priority ENR > PRV > CLM > TPA; most recent value for phone, email, address_line1, city, state, zip
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-428602 | CLM | 2026-03-23 | Aisha Rojasflagged | 1956-12-18 | — | — | 6374 Ocean Ave, Dallas, TX | Scored | 1.00 | — |
| CLM-428601 | CLM | 2026-09-25 | Aisha Rojasflagged | 1956-12-18 | UHC-94886-33 | 2988219286 | 6374 Ocean Ave, Dallas, TX | Scored | 1.00 | — |
| CLM-428603 | CLM | 2026-10-08 | Aisha Rojasflagged | 1956-12-18 | UHC-94886-33 | 2988219286 | 6374 Ocean Ave, Dallas, TX | Rule | 0.99 | D1 member id + dob exact |
Evidence
3 scored pairs among these records, expand a row for the per-field comparison
| A | B | Score | Method | Rule | Decision | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
▶CLM-428602CLMCLM-428601CLM1.00Scoredweighted similarityAuto-linked
Identifiers agreeing: 1Conflicts: noneGuard: none | ||||||||||||||||||||||||||||||
▶CLM-428601CLMCLM-428603CLM0.99RuleD1 member id + dob exactAuto-linked
Identifiers agreeing: 3Conflicts: noneGuard: none | ||||||||||||||||||||||||||||||
▶CLM-428602CLMCLM-428603CLM0.93Scoredweighted similarityAuto-linked
Identifiers agreeing: 1Conflicts: noneGuard: none | ||||||||||||||||||||||||||||||
Actions
What downstream consumers did with this identity
- Orphan claim re-pointedExecutedCLM-428602 → UHC-94886-33 (Aisha Rojas)ACT-007324, Claims processor
- Care coordination outreachProposedAisha Rojas: 3 claims, no attributed providerACT-019152, Next-best-action
Audit
Hash-chained entries touching this identity or its records
- 2026-10-19 19:54:38Record linked automatically1cd3102892matching_agent, CLM-428603, identity id MBR-021466, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-428601
- 2026-10-19 19:54:38Record linked automatically0128bfebacscoring_agent, CLM-428601, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428602, policy version 1
- 2026-10-19 19:54:38Record linked automatically49ed075ff3scoring_agent, CLM-428602, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428601, policy version 1
- 2026-10-19 19:52:09Record linked automatically5de2d5e4edmatching_agent, CLM-428603, identity id MBR-021466, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-428601
- 2026-10-19 19:52:09Record linked automatically0a2fd3494bscoring_agent, CLM-428601, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428602, policy version 1
- 2026-10-19 19:52:09Record linked automatically6290b8ac60scoring_agent, CLM-428602, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428601, policy version 1
- 2026-10-19 19:45:42Record linked automatically8abc470ceematching_agent, CLM-428603, identity id MBR-021466, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-428601
- 2026-10-19 19:45:42Record linked automaticallyff407c6007scoring_agent, CLM-428601, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428602, policy version 1
- 2026-10-19 19:45:42Record linked automatically1acd622727scoring_agent, CLM-428602, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428601, policy version 1
- 2026-10-19 19:32:31Record linked automatically7d79aa8ecdmatching_agent, CLM-428603, identity id MBR-021466, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-428601
- 2026-10-19 19:32:31Record linked automatically1c1ebee227scoring_agent, CLM-428601, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428602, policy version 1
- 2026-10-19 19:32:31Record linked automatically0f28454c39scoring_agent, CLM-428602, identity id MBR-021466, confidence 1, method probabilistic, matched record CLM-428601, policy version 1
- 2026-10-19 19:31:28Record linked automatically2f0da168b8scoring_agent, CLM-428603, identity id MBR-005097, confidence 1, method probabilistic, matched record CLM-428600, policy version 1
- 2026-10-19 19:31:28Record linked automatically14b087af65scoring_agent, CLM-428602, identity id MBR-005097, confidence 1, method probabilistic, matched record CLM-428600, policy version 1
- 2026-10-19 19:31:28Record linked automatically74b8f1a444scoring_agent, CLM-428601, identity id MBR-005097, confidence 1, method probabilistic, matched record CLM-428600, policy version 1
Claims for this member
Claims attached through the identity graph; holds follow open steward cases automatically
| Claim | Service | Provider | Procedures | Billed | Plan paid | Rules | Status |
|---|---|---|---|---|---|---|---|
| CLM-2026-027707 | 2026-09-21 | Riverside GI Associates in network | 88305, 45378 | $2,205.00 | $632.61 | Approved | Approved |
| CLM-2026-016414 | 2026-08-21 | Meadow Regional Medical Center in network | 71046 | $172.00 | $0.00 | Approved | Approved |
| CLM-2026-022637 | 2026-02-19 | Canyon Cardiovascular Associates in network | 93458, 93015 | $8,761.00 | — | Needs review | Needs review |