Identities/MBR-033403

Gold, golden identity

Heather I Lopez

5 source records from 3 feeds.

MBR-033403Verified5 records

Golden record

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

First nameENR: Heather
Middle nameENR: I
Last nameENR: Lopez
Date of birthENR: 1941-12-08
GenderENR: M
Member IDENR: UHC-55811-29
SSNENR: •••-••-8565
PhoneCLM: 5406316183
EmailTPA: heather.lopez@yahoo.com
AddressCLM: 2352 Ridge Rd
CityENR: Seattle
StateENR: WA
ZIP—: —
GroupENR: GRP-8353
PlanENR: MEDICARE-ADV-B

Min confidence

0.99

Sources

CLM ×3ENR ×1TPA ×1

Updated

2026-10-19 19:54:36

run-mvfoap9e

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-400950	CLM	2026-06-03	Heather Lopezflagged	1941-12-08	UHC-55811-29	5406316183	2352 Ridge Rd, Seattle, WA	Scored	1.00	—
ENR-101254	ENR	2026-07-06	Heather Lopezflagged	1941-12-08	UHC-55811-29	—	2352 Ridge Rd Apt 19, Seattle, WA	Scored	1.00	—
TPA-50434	TPA	2026-09-21	Heather Lopezflagged	1941-12-08	—	5406316183	2352 Ridge Rd, Seattle, WA	Scored	1.00	—
CLM-400948	CLM	2026-09-24	Heather Lopezflagged	1941-12-08	—	5406316183	2352 Ridge Rd, Seattle, WA	Scored	1.00	—
CLM-400949	CLM	2026-10-12	Heather Lopezflagged	1941-12-08	UHC-55811-29	5406316183	2352 Ridge Rd, Seattle, WA	Rule	0.99	D1 member id + dob exact

Evidence

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

Score

Method

Rule

Decision

▶CLM-400950CLMCLM-400948CLM1.00Scoredweighted 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-101254ENRCLM-400948CLM1.00Scoredweighted 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

▶TPA-50434TPACLM-400948CLM1.00Scoredweighted 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

▶CLM-400950CLMTPA-50434TPA1.00Scoredweighted 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-101254ENRTPA-50434TPA1.00Scoredweighted 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-400950CLMCLM-400949CLM 0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Member ID	1.00	4
Phone	1.00	1.5
Address	0.70	2	street_match

Identifiers agreeing: 3Conflicts: noneGuard: none

▶ENR-101254ENRCLM-400949CLM 0.99RuleD1 member id + dob exactAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Member ID	1.00	4
SSN (last four)	1.00	2.5
Address	0.70	2	street_match

Identifiers agreeing: 3Conflicts: noneGuard: none

▶CLM-400950CLMENR-101254ENR0.99RuleD1 member id + dob exactAuto-linked

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

Identifiers agreeing: 2Conflicts: noneGuard: none

▶TPA-50434TPACLM-400949CLM 0.94Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	0.70	2	street_match

Identifiers agreeing: 2Conflicts: noneGuard: none

▶CLM-400948CLMCLM-400949CLM 0.94Scoredweighted similarityAuto-linked

Field	Similarity	Weight	Note
Name	1.00	3
Date of birth	1.00	3	exact
Phone	1.00	1.5
Address	0.70	2	street_match

Identifiers agreeing: 2Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

Eligibility conflict resolvedProposed
Heather Lopez: 2 plan codes across sources → canonical MEDICARE-ADV-B
ACT-001202, Eligibility engine
Orphan claim re-pointedExecuted
CLM-400948 → UHC-55811-29 (Heather Lopez)
ACT-009253, Claims processor
Outreach address correctedProposed
Heather Lopez: 2352 Ridge Rd Apt 19, Seattle → 2352 Ridge Rd, Seattle
ACT-013099, Outreach
Care coordination outreachProposed
Heather Lopez: 3 claims, no attributed provider
ACT-019500, Next-best-action

Audit

Hash-chained entries touching this identity or its records

2026-10-19 19:54:38Record linked automatically28e6e5b5b7
matching_agent, CLM-400949, identity id MBR-033403, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400950
2026-10-19 19:54:38Record linked automatically8eb3048c0f
scoring_agent, CLM-400948, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:54:38Record linked automatically840d829104
scoring_agent, TPA-50434, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:54:38Record linked automaticallya8205731f6
scoring_agent, ENR-101254, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:54:38Record linked automaticallyc0faf11bb6
scoring_agent, CLM-400950, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:52:09Record linked automatically6bf3e01361
matching_agent, CLM-400949, identity id MBR-033403, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400950
2026-10-19 19:52:09Record linked automatically864fa00f8b
scoring_agent, CLM-400948, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:52:09Record linked automatically41fb0995c0
scoring_agent, TPA-50434, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:52:09Record linked automatically6d3cbc9361
scoring_agent, ENR-101254, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:52:09Record linked automatically0e2d963db0
scoring_agent, CLM-400950, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:45:42Record linked automaticallyb40a5445be
matching_agent, CLM-400949, identity id MBR-033403, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400950
2026-10-19 19:45:42Record linked automatically81669f8ddf
scoring_agent, CLM-400948, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:45:42Record linked automatically16f5e560db
scoring_agent, TPA-50434, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:45:42Record linked automaticallycbc9caeb5f
scoring_agent, ENR-101254, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:45:42Record linked automaticallyea3c3347ec
scoring_agent, CLM-400950, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:32:31Record linked automaticallyb91d1d82e5
matching_agent, CLM-400949, identity id MBR-033403, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-400950
2026-10-19 19:32:31Record linked automatically3e219ae807
scoring_agent, CLM-400948, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:32:31Record linked automaticallyaec68a0b6d
scoring_agent, TPA-50434, identity id MBR-033403, confidence 1, method probabilistic, matched record CLM-400950, policy version 1
2026-10-19 19:32:31Record linked automatically0e858e482b
scoring_agent, ENR-101254, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:32:31Record linked automatically8072b4a92f
scoring_agent, CLM-400950, identity id MBR-033403, confidence 1, method probabilistic, matched record TPA-50434, policy version 1
2026-10-19 19:31:28Record linked automatically1dab1378d8
scoring_agent, TPA-50434, identity id MBR-038900, confidence 1, method probabilistic, matched record CLM-401026, policy version 1
2026-10-19 19:31:28Record linked automatically3c4731dc4b
matching_agent, CLM-400949, identity id MBR-009583, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-101317
2026-10-19 19:31:28Record linked automatically0f1f25b0fe
matching_agent, CLM-400950, identity id MBR-009583, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-101317
2026-10-19 19:31:28Record linked automatically4bf77547c0
matching_agent, CLM-400948, identity id MBR-009583, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-101317

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-2026-005924	2026-09-04	Sunrise Diabetes Center in network	99215	$296.00	—	Denied	Denied
CLM-2026-030139	2026-08-14	Pinecrest Diagnostic Imaging in network	74177	$2,246.00	—	Denied	Denied
CLM-2026-034368	2026-05-09	Evergreen Counseling Center in network	90834, 90791	$610.00	$303.20	Approved	Approved