Identities/MBR-026388
Gold, golden identity

Kathleen G Graham

5 source records from 2 feeds.

MBR-026388Verified5 records

Golden record

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

First nameCLM
Kathleen
Middle nameCLM
G
Last nameCLM
Graham
Date of birthCLM
2000-12-23
GenderCLM
M
Member IDCLM
UHC-53630-10
SSNCLM
•••-••-1494
PhoneCLM
7855585868
Email—
—
AddressCLM
8422 Union St
CityCLM
Fresno
StateCLM
CA
ZIP—
—
GroupCLM
GRP-4746
PlanCLM
NAVIGATE-HMO
Min confidence
0.99
Sources
CLM ×4TPA ×1
Updated
2026-10-19 19:54:36
run-mvfoap9e

Identity graph

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

1.001.001.001.000.99CLMCLM-406622CLMCLM-406623TPATPA-52913CLMCLM-406624CLMCLM-406625IDMBR-026388
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-406622CLM2026-04-17Kathleen Grahamflagged2000-12-23—7855585868—Scored1.00—
CLM-406623CLM2026-06-27Kathy Grahamflagged2000-12-23——8422 Union St, Fresno, CAScored1.00—
TPA-52913TPA2026-07-25Kathleen Grahamflagged2000-12-23—78555858688422 Union St, Fresno, CAScored1.00—
CLM-406624CLM2026-08-04Kathleen Grahamflagged2000-12-23UHC-53630-1078555858688422 Union St, Fresno, CAScored1.00—
CLM-406625CLM2026-08-29Kathleen Grahamflagged2000-12-23UHC-53630-10—8422 Union St, Fresno, CARule0.99D1 member id + dob exact

Evidence

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

ABScoreMethodRuleDecision
▶CLM-406622CLMCLM-406624CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-406623CLMCLM-406624CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003nickname
Date of birth1.003exact
Address1.002exact
Identifiers agreeing: 1Conflicts: noneGuard: none
▶TPA-52913TPACLM-406624CLM1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-406622CLMTPA-52913TPA1.00Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Phone1.001.5
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-406624CLMCLM-406625CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
Address0.702street_match
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-406623CLMTPA-52913TPA0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003nickname
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-406623CLMCLM-406625CLM0.93Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003nickname
Date of birth1.003exact
Address0.702street_match
Identifiers agreeing: 1Conflicts: noneGuard: none
▶TPA-52913TPACLM-406625CLM0.93Scoredweighted similarityAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Address0.702street_match
Identifiers agreeing: 1Conflicts: noneGuard: none
▶CLM-406622CLMCLM-406623CLM0.83Scoredweighted similaritySent to steward
FieldSimilarityWeightNote
Name1.003nickname
Date of birth1.003exact
Identifiers agreeing: 0Conflicts: noneGuard: No identifier agrees
▶CLM-406622CLMCLM-406625CLM0.83Scoredweighted 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-406623 → UHC-53630-10 (Kathleen Graham)
    ACT-003890, Claims processor
  • Orphan claim re-pointedExecuted
    CLM-406622 → UHC-53630-10 (Kathleen Graham)
    ACT-003907, Claims processor
  • Care coordination outreachProposed
    Kathleen Graham: 4 claims, no attributed provider
    ACT-019332, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-19 19:54:38Record linked automaticallya10f09103b
    matching_agent, CLM-406625, identity id MBR-026388, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-406624
  • 2026-10-19 19:54:38Record linked automatically2cd2ec2275
    scoring_agent, CLM-406624, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:54:38Record linked automatically2808253bdf
    scoring_agent, TPA-52913, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:54:38Record linked automatically3d05e82af5
    scoring_agent, CLM-406623, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406624, policy version 1
  • 2026-10-19 19:54:38Record linked automatically6d9918a169
    scoring_agent, CLM-406622, identity id MBR-026388, confidence 1, method probabilistic, matched record TPA-52913, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallyf968432710
    matching_agent, CLM-406625, identity id MBR-026388, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-406624
  • 2026-10-19 19:52:09Record linked automaticallyffc0efd212
    scoring_agent, CLM-406624, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallycf339a38dc
    scoring_agent, TPA-52913, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:52:09Record linked automaticallycc5d6057ad
    scoring_agent, CLM-406623, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406624, policy version 1
  • 2026-10-19 19:52:09Record linked automatically2666bfd6b8
    scoring_agent, CLM-406622, identity id MBR-026388, confidence 1, method probabilistic, matched record TPA-52913, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallyf0688c6b44
    matching_agent, CLM-406625, identity id MBR-026388, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-406624
  • 2026-10-19 19:45:42Record linked automaticallyfb8ddebf87
    scoring_agent, CLM-406624, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallyd7c9978404
    scoring_agent, TPA-52913, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallyf3c174df4e
    scoring_agent, CLM-406623, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406624, policy version 1
  • 2026-10-19 19:45:42Record linked automaticallybe89fc7596
    scoring_agent, CLM-406622, identity id MBR-026388, confidence 1, method probabilistic, matched record TPA-52913, policy version 1
  • 2026-10-19 19:32:31Record linked automatically4869b5661e
    matching_agent, CLM-406625, identity id MBR-026388, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-406624
  • 2026-10-19 19:32:31Record linked automaticallycce9c723c0
    scoring_agent, CLM-406624, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:32:31Record linked automatically500a7c7363
    scoring_agent, TPA-52913, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406622, policy version 1
  • 2026-10-19 19:32:31Record linked automatically1376bab0c7
    scoring_agent, CLM-406623, identity id MBR-026388, confidence 1, method probabilistic, matched record CLM-406624, policy version 1
  • 2026-10-19 19:32:31Record linked automatically39e0466562
    scoring_agent, CLM-406622, identity id MBR-026388, confidence 1, method probabilistic, matched record TPA-52913, policy version 1
  • 2026-10-19 19:31:28Record linked automatically8cc91582f1
    scoring_agent, TPA-52913, identity id MBR-018181, confidence 0.99, method probabilistic, matched record TPA-52912, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallybcd157fa7b
    scoring_agent, CLM-406622, identity id MBR-017946, confidence 1, method probabilistic, matched record CLM-406623, policy version 1
  • 2026-10-19 19:31:28Record linked automatically71a89c55b4
    scoring_agent, CLM-406623, identity id MBR-017946, confidence 1, method probabilistic, matched record TPA-52933, policy version 1
  • 2026-10-19 19:31:28Record linked automatically7ba70946b0
    matching_agent, CLM-406625, identity id MBR-007115, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-108679
  • 2026-10-19 19:31:28Record linked automatically535f19994e
    scoring_agent, CLM-406624, identity id MBR-007115, confidence 0.99, method probabilistic, matched record TPA-52935, policy version 1

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0326642026-08-12Pinecrest Medical Group
in network
99214, 99215$660.00$384.20ApprovedApproved
CLM-2026-0090672026-07-31Cornerstone Orthopedic Specialists
out of network
27447$38,026.00—DeniedDenied
CLM-2026-0098102026-05-24Evergreen Orthopedic Specialists
in network
27447$40,394.00—Needs reviewNeeds review
CLM-2026-0098602026-03-09Riverside Primary Care Associates
in network
99213, 36415$227.00$115.74ApprovedApproved