Identities/MBR-023759
Gold, golden identity

Andrea Ortiz

5 source records from 2 feeds.

MBR-023759Verified5 records

Golden record

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

First nameENR
Andrea
Middle name—
—
Last nameENR
Ortiz
Date of birthENR
1980-09-18
GenderENR
M
Member IDENR
UHC-56559-86
SSNENR
•••-••-4993
PhoneENR
3729069609
EmailENR
andrea.ortiz@hotmail.com
AddressENR
662 Union St
CityENR
Tucson
StateENR
AZ
ZIPENR
85792
GroupENR
GRP-9784
PlanENR
CORE-HMO
Min confidence
0.99
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

1.001.000.991.001.00CLMCLM-430364ENRENR-139858CLMCLM-430367CLMCLM-430365CLMCLM-430366IDMBR-023759
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

RecordSourceReceivedNameDOBMember IDPhoneAddressMethodConfidenceRule
CLM-430364CLM2026-04-03Andrea Ortizflagged1980-09-18UHC-56559-86—662 Union St, Tucson, AZScored1.00—
ENR-139858ENR2026-04-30Andrea Ortizflagged1980-09-18UHC-56559-863729069609662 Union St, Tucson, AZScored1.00—
CLM-430367CLM2026-05-15Andrea Ortizflagged1980-09-18UHC-56559-86——Rule0.99D1 member id + dob exact
CLM-430365CLM2026-07-07Andrea Ortizflagged1980-09-18——662 Union St, Tucson, AZScored1.00—
CLM-430366CLM2026-09-23Andrea Ortizflagged1980-09-18—3729069609662 Union St, Tucson, AZScored1.00—

Evidence

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

ABScoreMethodRuleDecision
▶CLM-430364CLMCLM-430365CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-139858ENRCLM-430365CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-430364CLMCLM-430366CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-139858ENRCLM-430366CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-430365CLMCLM-430366CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-430364CLMCLM-430367CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-139858ENRCLM-430367CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-430364CLMENR-139858ENR0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Email1.001.5
Address1.002exact
Identifiers agreeing: 3Conflicts: noneGuard: none
▶CLM-430367CLMCLM-430365CLM0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees
▶CLM-430367CLMCLM-430366CLM0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees

Actions

What downstream consumers did with this identity

  • Orphan claim re-pointedExecuted
    CLM-430365 → UHC-56559-86 (Andrea Ortiz)
    ACT-001760, Claims processor
  • Orphan claim re-pointedExecuted
    CLM-430366 → UHC-56559-86 (Andrea Ortiz)
    ACT-006177, Claims processor
  • Care coordination outreachProposed
    Andrea Ortiz: 4 claims, no attributed provider
    ACT-019249, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-19 19:54:38Record linked automaticallya910b218dd
    scoring_agent, CLM-430366, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallye5661f5a26
    scoring_agent, CLM-430365, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:54:38Record linked automatically009c4c772d
    matching_agent, CLM-430367, identity id MBR-023759, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-430364
  • 2026-10-19 19:54:38Record linked automaticallyf0027c021e
    scoring_agent, ENR-139858, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:54:38Record linked automaticallyde7684532c
    scoring_agent, CLM-430364, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallyfa48ea50ca
    scoring_agent, CLM-430366, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:52:09Record linked automatically56c4979e56
    scoring_agent, CLM-430365, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallyc282803886
    matching_agent, CLM-430367, identity id MBR-023759, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-430364
  • 2026-10-19 19:52:09Record linked automaticallya747891ef8
    scoring_agent, ENR-139858, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:52:09Record linked automatically171390ba12
    scoring_agent, CLM-430364, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:45:42Record linked automatically94d47f3014
    scoring_agent, CLM-430366, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallydeca9e15fa
    scoring_agent, CLM-430365, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:45:42Record linked automatically8493c87cdd
    matching_agent, CLM-430367, identity id MBR-023759, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-430364
  • 2026-10-19 19:45:42Record linked automatically405ac6ee28
    scoring_agent, ENR-139858, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:45:42Record linked automatically9f8ffff347
    scoring_agent, CLM-430364, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:32:31Record linked automatically6b2636b329
    scoring_agent, CLM-430366, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:32:31Record linked automatically2090fa960a
    scoring_agent, CLM-430365, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430364, policy version 1
  • 2026-10-19 19:32:31Record linked automaticallycc7e2f1601
    matching_agent, CLM-430367, identity id MBR-023759, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-430364
  • 2026-10-19 19:32:31Record linked automatically1266a59e9c
    scoring_agent, ENR-139858, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:32:31Record linked automatically098fa76416
    scoring_agent, CLM-430364, identity id MBR-023759, confidence 1, method probabilistic, matched record CLM-430365, policy version 1
  • 2026-10-19 19:31:28Record linked automatically3ac9712b1b
    matching_agent, CLM-430365, identity id MBR-039446, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-140041
  • 2026-10-19 19:31:28Record linked automaticallyb2b4d2672d
    scoring_agent, CLM-430367, identity id MBR-038969, confidence 1, method probabilistic, matched record PRV-28884, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallyfe80d52e26
    scoring_agent, ENR-139858, identity id MBR-029224, confidence 1, method probabilistic, matched record CLM-430223, policy version 1
  • 2026-10-19 19:31:28Record linked automatically5d90d13b24
    scoring_agent, CLM-430366, identity id MBR-009646, confidence 1, method probabilistic, matched record ENR-140044, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallya873bc1e93
    matching_agent, CLM-430364, identity id MBR-000364, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-140039

Claims for this member

Claims attached through the identity graph; holds follow open steward cases automatically

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0181872026-08-21Northgate Internal Medicine Associates
in network
70553$3,376.00—Needs reviewNeeds review
CLM-2026-0016992026-06-04Evergreen Internal Medicine Associates
in network
93000$67.00$1.54ApprovedApproved
CLM-2026-0286322026-04-07Sunrise Cardiovascular Associates
out of network
93224, 99214$563.00—DeniedDenied
CLM-2026-0201772026-03-20Evergreen Family Practice
in network
70553$3,599.00—Needs reviewNeeds review