AccountId: 011433970860
ContactId: 02349fb3-3c75-42ed-9c70-efdb5b123dd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283890 ms
Total Talk Time (AGENT): 115389 ms
Total Talk Time (CUSTOMER): 88401 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/02349fb3-3c75-42ed-9c70-efdb5b123dd6_20250211T20:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Fostoria Hospital, and I would like to check on a claim.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. May I have the member's policy number?
[CUSTOMER][NEUTRAL] D 404-08751
[AGENT][NEUTRAL] All right. Do you have the member's ID card available?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] On the card, do you see anywhere that says inhospital or outpatient policy cert number?
[CUSTOMER][NEUTRAL] Employee ID employee name, medical coverage employee group number 9404.
[CUSTOMER][NEUTRAL] This is pharmacy this is has vision.
[AGENT][NEUTRAL] That does, do you see APL to the top left corner?
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Of the card.
[CUSTOMER][NEUTRAL] I'm gonna say that they probably cut that part of the card off.
[AGENT][NEUTRAL] You said you saw something of vision on there?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you have the member?
[CUSTOMER][NEUTRAL] This says for medical benefits verification customer service please call 90 Degree benefits claim submission to benefits and a card.
[AGENT][NEUTRAL] Mhm, that's that the number.
[AGENT][NEUTRAL] Right, OK. So that the number that you gave, that's the policy number for 90 Degree, that's why I can't use it, but now that makes sense if that's on the card. Um, I can see if there's a
[CUSTOMER][NEUTRAL] Pardon?
[AGENT][NEUTRAL] I can look it up with the member's first and last name or if you have their full social.
[CUSTOMER][NEUTRAL] To pay their social.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And what is the member's first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] And you said this is for medical, right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So I'm pulling up the policy now, and I just need you to verify the date of birth and I can give you this policy number as well.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment and that policy number is 254-4385.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $3,473.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claims?
[CUSTOMER][NEUTRAL] It's for Fostoria Community Hospital.
[AGENT][NEUTRAL] Yeah, we only received 2 claims on that data service, but it's a different provider and it's way lower than your total bill. So there's no claim on file for the member for that data service.
[CUSTOMER][NEUTRAL] OK, so I need to update that member ID number we billed with and then does the claim go to [PII]?
[AGENT][POSITIVE] Yeah, that's correct.
[CUSTOMER][NEUTRAL] OK, so the member ID I should be billing with is that 254 number you gave me, right?
[AGENT][NEUTRAL] Yes, ma'am, 254-438-5.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and was the patient eligible for that data service, the [PII]?
[AGENT][NEUTRAL] Let me make sure, hold on one moment.
[AGENT][NEUTRAL] Well, yes, the policy has been active since [PII] and it's still active now. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then just a call reference number.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][POSITIVE] Nope have a good day.
[AGENT][POSITIVE] You also, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.