Identities/MBR-025909
Gold, golden identity

Dorothy Riley

6 source records from 3 feeds.

MBR-025909Verified6 records

Golden record

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

First nameENR
Dorothy
Middle name—
—
Last nameENR
Riley
Date of birthENR
1986-06-13
GenderENR
F
Member IDENR
UHC-58212-49
SSNENR
•••-••-2764
PhoneENR
8559264082
EmailENR
dorothy.riley45@gmail.com
AddressENR
6622 Sunset Blvd
CityENR
Houston
StateENR
TX
ZIPENR
77075
GroupENR
GRP-9346
PlanENR
NAVIGATE-HMO
Min confidence
0.87
Sources
ENR ×1CLM ×3TPA ×2
Updated
2026-10-22 12:43:43
run-mvjj6udb

Identity graph

Source records linked to this identity and the confidence of each link

0.991.001.000.870.970.99ENRENR-127768CLMCLM-421160CLMCLM-421159TPATPA-59302TPATPA-59303CLMCLM-421158IDMBR-025909
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
ENR-127768ENR2026-04-15Dorothy Rileyflagged1986-06-13UHC-58212-4985592640826622 Sunset Blvd, Houston, TXRule0.99D1 member id + dob exact
CLM-421160CLM2026-05-16Dorothy Rileyflagged1986-06-13—8559264082—Scored1.00—
CLM-421159CLM2026-06-27Dorothy Rileyflagged1986-06-13UHC-58212-4985592640826622 Sunset Blvd, Houston, TXScored1.00—
TPA-59302TPA2026-07-22Dorothy Rileyflagged1986-06-31—8559264082—Scored0.87—
TPA-59303TPA2026-08-19Dorothy Rileyflagged1986-06-13———Rule0.97D2 ssn4 + dob + last name
CLM-421158CLM2026-10-04Dorothy Rileyflagged1986-06-13UHC-58212-498559264082—Rule0.99D1 member id + dob exact

Evidence

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

ABScoreMethodRuleDecision
▶CLM-421160CLMCLM-421159CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-127768ENRCLM-421158CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Identifiers agreeing: 3Conflicts: noneGuard: none
▶CLM-421159CLMCLM-421158CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Phone1.001.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶ENR-127768ENRCLM-421159CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Phone1.001.5
Email1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶CLM-421160CLMCLM-421158CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Phone1.001.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶TPA-59303TPACLM-421158CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-127768ENRCLM-421160CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Phone1.001.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶ENR-127768ENRTPA-59303TPA0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-421160CLMTPA-59303TPA0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶ENR-127768ENRTPA-59302TPA0.87Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth0.603transposition
Phone1.001.5
Email1.001.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-421159CLMTPA-59302TPA0.87Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth0.603transposition
Phone1.001.5
Email1.001.5
Identifiers agreeing: 2Conflicts: noneGuard: none
▶TPA-59302TPACLM-421158CLM0.84Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth0.603transposition
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-421160CLMTPA-59302TPA0.84Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth0.603transposition
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-421159CLMTPA-59303TPA0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees
▶TPA-59302TPATPA-59303TPA0.80Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003
Date of birth0.603transposition
Identifiers agreeing: 0Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

  • Orphan claim re-pointedExecuted
    CLM-421160 → UHC-58212-49 (Dorothy Riley)
    ACT-005751, Claims processor
  • Care coordination outreachProposed
    Dorothy Riley: 3 claims, no attributed provider
    ACT-019317, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-22 12:43:54Record linked automatically91f1c5389e
    matching_agent, CLM-421158, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-127768
  • 2026-10-22 12:43:54Record linked automatically7c3f277021
    matching_agent, TPA-59303, identity id MBR-025909, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127768
  • 2026-10-22 12:43:54Record linked automatically3c6d70317c
    scoring_agent, TPA-59302, identity id MBR-025909, confidence 0.87, method probabilistic, matched record ENR-127768, policy version 1
  • 2026-10-22 12:43:54Record linked automatically39f1140a93
    scoring_agent, CLM-421159, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421160, policy version 1
  • 2026-10-22 12:43:54Record linked automatically458694c97b
    scoring_agent, CLM-421160, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421159, policy version 1
  • 2026-10-22 12:43:54Record linked automaticallya67ac1dd78
    matching_agent, ENR-127768, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-421159
  • 2026-10-19 19:54:38Record linked automatically656c4c4ec5
    matching_agent, CLM-421158, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-127768
  • 2026-10-19 19:54:38Record linked automaticallybd53e140d8
    matching_agent, TPA-59303, identity id MBR-025909, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127768
  • 2026-10-19 19:54:38Record linked automatically2802f85cf1
    scoring_agent, TPA-59302, identity id MBR-025909, confidence 0.87, method probabilistic, matched record ENR-127768, policy version 1
  • 2026-10-19 19:54:38Record linked automatically081b149800
    scoring_agent, CLM-421159, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421160, policy version 1
  • 2026-10-19 19:54:38Record linked automatically872f049a0b
    scoring_agent, CLM-421160, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421159, policy version 1
  • 2026-10-19 19:54:38Record linked automatically27d50a42b0
    matching_agent, ENR-127768, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-421159
  • 2026-10-19 19:52:09Record linked automaticallyed81e5eb3c
    matching_agent, CLM-421158, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-127768
  • 2026-10-19 19:52:09Record linked automatically57c7d7ff7a
    matching_agent, TPA-59303, identity id MBR-025909, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127768
  • 2026-10-19 19:52:09Record linked automatically35c1394476
    scoring_agent, TPA-59302, identity id MBR-025909, confidence 0.87, method probabilistic, matched record ENR-127768, policy version 1
  • 2026-10-19 19:52:09Record linked automatically48a9474558
    scoring_agent, CLM-421159, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421160, policy version 1
  • 2026-10-19 19:52:09Record linked automatically1b503ad301
    scoring_agent, CLM-421160, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421159, policy version 1
  • 2026-10-19 19:52:09Record linked automatically0e9648be0e
    matching_agent, ENR-127768, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-421159
  • 2026-10-19 19:45:42Record linked automatically92b48e0398
    matching_agent, CLM-421158, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-127768
  • 2026-10-19 19:45:42Record linked automatically446c1775fa
    matching_agent, TPA-59303, identity id MBR-025909, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127768
  • 2026-10-19 19:45:42Record linked automatically836973acf4
    scoring_agent, TPA-59302, identity id MBR-025909, confidence 0.87, method probabilistic, matched record ENR-127768, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallyf52a7a0861
    scoring_agent, CLM-421159, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421160, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallycbb59f73f3
    scoring_agent, CLM-421160, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421159, policy version 1
  • 2026-10-19 19:45:42Record linked automatically9bd8ae0ad1
    matching_agent, ENR-127768, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-421159
  • 2026-10-19 19:32:31Record linked automatically16866a65df
    matching_agent, CLM-421158, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-127768
  • 2026-10-19 19:32:31Record linked automatically27554bc9c5
    matching_agent, TPA-59303, identity id MBR-025909, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127768
  • 2026-10-19 19:32:31Record linked automatically5a75293d53
    scoring_agent, TPA-59302, identity id MBR-025909, confidence 0.87, method probabilistic, matched record ENR-127768, policy version 1
  • 2026-10-19 19:32:31Record linked automatically4c05e73094
    scoring_agent, CLM-421159, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421160, policy version 1
  • 2026-10-19 19:32:31Record linked automatically87270034bc
    scoring_agent, CLM-421160, identity id MBR-025909, confidence 1, method probabilistic, matched record CLM-421159, policy version 1
  • 2026-10-19 19:32:31Record linked automatically0c19a50857
    matching_agent, ENR-127768, identity id MBR-025909, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-421159
  • 2026-10-19 19:31:28Record linked automaticallyefb2fd0c10
    matching_agent, CLM-421160, identity id MBR-040898, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127777
  • 2026-10-19 19:31:28Record linked automatically58a96389d4
    matching_agent, ENR-127768, identity id MBR-033625, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-421155
  • 2026-10-19 19:31:28Record linked automaticallybbe9b206a7
    matching_agent, CLM-421158, identity id MBR-023758, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-127773
  • 2026-10-19 19:31:28Record linked automatically141812c709
    matching_agent, CLM-421159, identity id MBR-023758, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-127773
  • 2026-10-19 19:31:28Record linked automaticallyea44cf3d85
    scoring_agent, TPA-59303, identity id MBR-014894, confidence 1, method probabilistic, matched record CLM-421295, policy version 1
  • 2026-10-19 19:31:28Record linked automatically0580eebc31
    scoring_agent, TPA-59302, identity id MBR-010474, confidence 1, method probabilistic, matched record PRV-26252, policy version 1

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0179992026-09-18Sunrise Medical Group
in network
93000, 99215$459.00$254.58ApprovedApproved
CLM-2026-0321182026-06-01Valley Family Practice
in network
36415$18.00$0.00ApprovedApproved
CLM-2026-0166522026-04-13Pinecrest Family Practice
in network
36415$15.00$0.00ApprovedApproved