Identities/MBR-034425
Gold, golden identity

Shirley Q Rojas

5 source records from 3 feeds.

MBR-034425Verified5 records

Golden record

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

First nameENR
Shirley
Middle nameENR
Q
Last nameENR
Rojas
Date of birthENR
1966-01-02
GenderENR
M
Member IDENR
UHC-61087-91
SSNENR
•••-••-4385
PhoneENR
7065069754
EmailCLM
shirley.rojas@gmail.com
AddressENR
4695 Indian School Rd
CityENR
Fresno
StateENR
CA
ZIPENR
93760
GroupENR
GRP-9951
PlanENR
NAVIGATE-HMO
Min confidence
0.97
Sources
TPA ×1ENR ×1CLM ×3
Updated
2026-10-22 12:43:43
run-mvjj6udb

Identity graph

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

0.970.990.970.990.99TPATPA-63113ENRENR-138921CLMCLM-429664CLMCLM-429662CLMCLM-429663IDMBR-034425
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
TPA-63113TPA2026-06-10Shirley Rojasflagged1966-01-02——4695 Indian School Rd, Fresno, CARule0.97D2 ssn4 + dob + last name
ENR-138921ENR2026-08-24Shirley Rojasflagged1966-01-02UHC-61087-9170650697544695 Indian School Rd, Fresno, CARule0.99D1 member id + dob exact
CLM-429664CLM2026-09-07Shirley Rojasflagged1966-01-02——4695 Indian School Rd, Fresno, CARule0.97D2 ssn4 + dob + last name
CLM-429662CLM2026-10-02Shirley Rojasflagged1966-01-02UHC-61087-9170650697544695 Indian School Rd, Fresno, CARule0.99D1 member id + dob exact
CLM-429663CLM2026-10-02Shirley Rojasflagged1966-01-02UHC-61087-9170650697544695 Indian School Rd, Fresno, CARule0.99D1 member id + dob exact

Evidence

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

ABScoreMethodRuleDecision
▶ENR-138921 ENRCLM-429662CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶ENR-138921 ENRCLM-429663CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶CLM-429662CLMCLM-429663CLM0.99RuleD1 member id + dob exactAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
Member ID1.004
SSN (last four)1.002.5
Phone1.001.5
Address1.002exact
Identifiers agreeing: 4Conflicts: noneGuard: none
▶TPA-63113TPA CLM-429662CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-429664CLMCLM-429662CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶TPA-63113TPA CLM-429663CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶CLM-429664CLMCLM-429663CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶TPA-63113TPA CLM-429664CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶ENR-138921 ENRCLM-429664CLM0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none
▶TPA-63113TPA ENR-138921 ENR0.97RuleD2 ssn4 + dob + last nameAuto-linked
FieldSimilarityWeightNote
Name1.003
Date of birth1.003exact
SSN (last four)1.002.5
Address1.002exact
Identifiers agreeing: 2Conflicts: noneGuard: none

Actions

What downstream consumers did with this identity

  • Eligibility conflict resolvedProposed
    Shirley Rojas: 2 plan codes across sources → canonical NAVIGATE-HMO
    ACT-001227, Eligibility engine
  • Orphan claim re-pointedExecuted
    CLM-429664 → UHC-61087-91 (Shirley Rojas)
    ACT-010057, Claims processor
  • Care coordination outreachProposed
    Shirley Rojas: 3 claims, no attributed provider
    ACT-019516, Next-best-action

Audit

Hash-chained entries touching this identity or its records

  • 2026-10-22 12:43:55Record linked automatically5307920304
    matching_agent, CLM-429663, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-22 12:43:55Record linked automaticallyd67998d323
    matching_agent, CLM-429662, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-22 12:43:55Record linked automatically656c761df5
    matching_agent, CLM-429664, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-63113
  • 2026-10-22 12:43:55Record linked automatically75d99fb607
    matching_agent, ENR-138921, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429662
  • 2026-10-22 12:43:55Record linked automatically56d0450ac9
    matching_agent, TPA-63113, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-138921
  • 2026-10-19 19:54:39Record linked automaticallyece6ac0e0a
    matching_agent, CLM-429663, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:54:39Record linked automatically73149057e1
    matching_agent, CLM-429662, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:54:39Record linked automatically3cf4e6c649
    matching_agent, CLM-429664, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-63113
  • 2026-10-19 19:54:39Record linked automaticallyab0b94ecda
    matching_agent, ENR-138921, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429662
  • 2026-10-19 19:54:39Record linked automatically01bf3a96c2
    matching_agent, TPA-63113, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-138921
  • 2026-10-19 19:52:09Record linked automatically7c6d93c8a2
    matching_agent, CLM-429663, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:52:09Record linked automaticallyeacb2dea06
    matching_agent, CLM-429662, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:52:09Record linked automaticallyf749ed5c84
    matching_agent, CLM-429664, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-63113
  • 2026-10-19 19:52:09Record linked automatically8e64b8039c
    matching_agent, ENR-138921, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429662
  • 2026-10-19 19:52:09Record linked automatically61c6c9932d
    matching_agent, TPA-63113, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-138921
  • 2026-10-19 19:45:42Record linked automatically9978a980a4
    matching_agent, CLM-429663, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:45:42Record linked automatically4c88f374e5
    matching_agent, CLM-429662, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:45:42Record linked automatically4a622726bb
    matching_agent, CLM-429664, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-63113
  • 2026-10-19 19:45:42Record linked automatically5edae130cd
    matching_agent, ENR-138921, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429662
  • 2026-10-19 19:45:42Record linked automatically71a60fb8bd
    matching_agent, TPA-63113, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-138921
  • 2026-10-19 19:32:31Record linked automaticallybb7cb1c909
    matching_agent, CLM-429663, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:32:31Record linked automatically35a8dfca9f
    matching_agent, CLM-429662, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-138921
  • 2026-10-19 19:32:31Record linked automaticallyc2bebe6740
    matching_agent, CLM-429664, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record TPA-63113
  • 2026-10-19 19:32:31Record linked automaticallya5d36b683e
    matching_agent, ENR-138921, identity id MBR-034425, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record CLM-429662
  • 2026-10-19 19:32:31Record linked automatically89c5625a62
    matching_agent, TPA-63113, identity id MBR-034425, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record ENR-138921
  • 2026-10-19 19:31:28Record linked automatically536937a44e
    matching_agent, ENR-138921, identity id MBR-033331, confidence 0.97, rule D2 ssn4 + dob + last name, method deterministic, matched record CLM-429482
  • 2026-10-19 19:31:28Record linked automaticallyb1e9084936
    matching_agent, CLM-429663, identity id MBR-026538, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-139173
  • 2026-10-19 19:31:28Record linked automatically88a47ca773
    scoring_agent, TPA-63113, identity id MBR-014581, confidence 1, method probabilistic, matched record TPA-63112, policy version 1
  • 2026-10-19 19:31:28Record linked automaticallyb85d846ab5
    matching_agent, CLM-429662, identity id MBR-011815, confidence 0.99, rule D1 member_id + dob exact, method deterministic, matched record ENR-139170
  • 2026-10-19 19:31:28Record linked automatically7f0c0e21af
    matching_agent, CLM-429664, identity id MBR-008917, confidence 0.96, rule D3 member_id + name, method deterministic, matched record ENR-139176

Claims for this member

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

All claims
ClaimServiceProviderProceduresBilledPlan paidRulesStatus
CLM-2026-0187652026-08-20Evergreen Family Practice
in network
99214, 90471, 99203$520.00$297.40ApprovedApproved
CLM-2026-0046602026-08-28Evergreen Medical Group
in network
99213, 99203, 99214$575.00$331.50ApprovedApproved
CLM-2026-0331832026-08-04Evergreen Medical Group
in network
99395$238.00$122.56ApprovedApproved