Match the same member across eligibility, claims, and program files without a shared ID

Last reviewed
October 23, 2026
TL;DR

Data Nexus by Dart Health resolves each person across every feed it receives, even when the HR system, the carrier, and the claims vendor each use a different ID. It finds identifiers that stay consistent across sources and keeps each identity stable as files change. Any match it can't make with confidence goes to a person. Resolution runs at over 99% across about 3 million records a month.

99%+
identity resolution
3M
records a month
HIPAA
SOC 2 Type II

Most benefits data has no shared ID to match on

The HR system uses an employee number, the carrier uses a subscriber ID, and a claims vendor may send only a name and a date of birth. Claims data is organized around payments and engagement data around providers, so neither is organized around the person.

Names and addresses change between files. Dependents often appear in one feed and not the others. A program that can't link a claim to the right enrolled member can't prove its outcomes to the employer paying for it.

How separate IDs become one member

  • We map each source to the same benefits member model.
  • AI finds the combinations of identifiers that stay consistent across sources, so a match doesn't hinge on any single ID.
  • Confident matches join one member record. Matches below the confidence bar go to a person for review.
  • Each identity stays stable as files change underneath it, including when an employer changes HR systems.
  • Your product reads one member through the API, with eligibility, claims, programs, and enrollments attached. Enterprise plans add leave data.

Example: the HR system sends emp_id 4471, carrier eligibility sends sub_id A-9902, and a claims vendor sends only name and date of birth. All 3 resolve to one member, plus a spouse and child the HR system never returned.

The numbers

Identity resolution runs above 99% across eligibility, claims, provider visits, and benefits, on about 3 million records a month.

FAQ

Do dependents get their own member record?

Yes. We resolve dependents like any other member, including those who appear in only one feed.

What happens when two records might be the same person?

If the match isn't confident, a person on our team reviews it. We don't merge records on a guess.

Does a member keep the same identity when the employer changes systems?

Yes. Identity doesn't depend on any one system's ID, so a new HR system or carrier ID attaches to the existing member.

Can we update a member record directly?

Yes. You can update member records through the API without waiting for the next file.

What this doesn't do

  • It doesn't merge two records on a low-confidence match.
  • It isn't a hospital patient index or an HL7 or FHIR integration with EHRs. Use Redox for that.

Bring an eligibility file and a claims file from the same employer.

We'll walk through how they resolve to one member, on a 30-minute call.

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