Randy M Riley

4 source records from 3 feeds.

MBR-032268Verified4 records

Golden record

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

First nameENR: Randy
Middle nameENR: M
Last nameCLM: Riley
Date of birthENR: 1975-07-01
GenderENR: F
Member IDENR: UHC-06936-55
SSNENR: •••-••-2837
PhoneENR: 3255105808
EmailENR: randy.riley@icloud.com
AddressENR: 2611 Jefferson Ave
CityENR: Plano
StateENR: TX
ZIPENR: 75054
GroupENR: GRP-6159
PlanENR: SELECT-EPO

Min confidence

0.99

Sources

CLM ×2ENR ×1TPA ×1

Updated

2026-10-22 12:43:43

run-mvjj6udb

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-432715	CLM	2026-05-25	Randy Rileyflagged	1975-07-01	—	—	2611 Jefferson Ave, Plano, TX	Scored	1.00	—
CLM-432716	CLM	2026-06-09	Randy Rileyflagged	1975-07-01	—	3255105808	2611 Jefferson Ave, Plano, TX	Scored	1.00	—
ENR-142959	ENR	2026-06-27	Randy Rielyflagged	1975-07-01	UHC-06936-55	3255105808	2611 Jefferson Ave, Plano, TX	Rule	0.99	D1 member id + dob exact
TPA-64432	TPA	2026-10-03	Randy Rileyflagged	1975-07-01	UHC-06936-55	3255105808	2611 Jefferson Ave, Plano, TX	Scored	1.00	—

Evidence

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

Score

Method

Rule

Decision

▶CLM-432715CLMTPA-64432TPA1.00Scoredweighted 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-432716CLM TPA-64432TPA1.00Scoredweighted 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

▶ENR-142959ENRTPA-64432TPA0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Phone	1.00	1.5
Email	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 4Conflicts: noneGuard: none

▶CLM-432715CLMCLM-432716CLM 0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-432715CLMENR-142959ENR0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5
Address	1.00	2	exact

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-432716CLM ENR-142959ENR0.97RuleD2 ssn4 + dob + last nameAuto-linked

Field	Similarity	Weight	Note
Name	0.97	3
Date of birth	1.00	3	exact
SSN (last four)	1.00	2.5
Phone	1.00	1.5
Address	1.00	2	exact

Identifiers agreeing: 3Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Orphan claim re-pointedExecuted
CLM-432716 → UHC-06936-55 (Randy Riley)
ACT-004780, Claims processor
Orphan claim re-pointedExecuted
CLM-432715 → UHC-06936-55 (Randy Riley)
ACT-007587, Claims processor

Audit

Hash-chained entries touching this identity or its records

2026-10-22 12:43:54Record linked automatically8ceeb4076b
scoring_agent, TPA-64432, identity id MBR-032268, confidence 1, method probabilistic, matched record CLM-432715, policy version 1
2026-10-22 12:43:54Record linked automatically4db7cecf9a
matching_agent, ENR-142959, identity id MBR-032268, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record TPA-64432
2026-10-22 12:43:54Record linked automatically3a3a7f1a78
scoring_agent, CLM-432716, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-22 12:43:54Record linked automatically795e9962bc
scoring_agent, CLM-432715, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:54:38Record linked automatically723525733c
scoring_agent, TPA-64432, identity id MBR-032268, confidence 1, method probabilistic, matched record CLM-432715, policy version 1
2026-10-19 19:54:38Record linked automatically5f37220a42
matching_agent, ENR-142959, identity id MBR-032268, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record TPA-64432
2026-10-19 19:54:38Record linked automatically323359d454
scoring_agent, CLM-432716, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:54:38Record linked automatically609fea25e1
scoring_agent, CLM-432715, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:52:09Record linked automaticallyc21f481102
scoring_agent, TPA-64432, identity id MBR-032268, confidence 1, method probabilistic, matched record CLM-432715, policy version 1
2026-10-19 19:52:09Record linked automatically4212be6cc1
matching_agent, ENR-142959, identity id MBR-032268, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record TPA-64432
2026-10-19 19:52:09Record linked automaticallya89887e12c
scoring_agent, CLM-432716, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:52:09Record linked automaticallyf6ed2d836f
scoring_agent, CLM-432715, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:45:42Record linked automatically686a573cda
scoring_agent, TPA-64432, identity id MBR-032268, confidence 1, method probabilistic, matched record CLM-432715, policy version 1
2026-10-19 19:45:42Record linked automaticallyea29c8f9d5
matching_agent, ENR-142959, identity id MBR-032268, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record TPA-64432
2026-10-19 19:45:42Record linked automatically3ee4baf7d3
scoring_agent, CLM-432716, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:45:42Record linked automaticallya12677cc82
scoring_agent, CLM-432715, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:32:31Record linked automatically988c9e6720
scoring_agent, TPA-64432, identity id MBR-032268, confidence 1, method probabilistic, matched record CLM-432715, policy version 1
2026-10-19 19:32:31Record linked automatically63010b34e2
matching_agent, ENR-142959, identity id MBR-032268, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record TPA-64432
2026-10-19 19:32:31Record linked automatically9742142a96
scoring_agent, CLM-432716, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:32:31Record linked automaticallydd6a118995
scoring_agent, CLM-432715, identity id MBR-032268, confidence 1, method probabilistic, matched record TPA-64432, policy version 1
2026-10-19 19:31:28Record linked automaticallybce3f5d955
scoring_agent, ENR-142959, identity id MBR-037357, confidence 1, method probabilistic, matched record CLM-432587, policy version 1
2026-10-19 19:31:28Record linked automaticallyce9b0387e4
scoring_agent, CLM-432716, identity id MBR-016278, confidence 1.00, method probabilistic, matched record TPA-64304, policy version 1
2026-10-19 19:31:28Record linked automaticallyeead47034c
matching_agent, CLM-432715, identity id MBR-006151, confidence 0.96, rule D3 member_id + name, method deterministic, matched record CLM-432714

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-2026-013088	2026-05-13	Mesa Diabetes Center in network	99214, 99215	$758.00	—	Denied	Denied
CLM-2026-023653	2026-04-12	Sunrise Cardiovascular Associates out of network	99214	$332.00	—	Denied	Denied