AccountId: 011433970860
ContactId: 03ddf90d-8540-4ee4-92da-7ad5d6ca9091
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241020 ms
Total Talk Time (AGENT): 98995 ms
Total Talk Time (CUSTOMER): 82529 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/03ddf90d-8540-4ee4-92da-7ad5d6ca9091_20250106T14:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], good morning. This is [PII] calling from Mount Sinai Medical Center. I need to verify if you guys received a claim for a member.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim, and Genesis, may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] And then the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] Policy number is 01810313.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, that will be [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] This is for [PII] with the bill amount 5,77584 after primary paid 1,68147.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] That claim number is 348.
[AGENT][NEUTRAL] 760.
[CUSTOMER][NEUTRAL] 3 hotels.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the claim number?
[AGENT][NEUTRAL] 348.
[AGENT][NEUTRAL] 7600.
[AGENT][NEUTRAL] And on
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, did you guys pay it or still in process?
[AGENT][NEUTRAL] So, on [PII], the claim was denied?
[AGENT][NEUTRAL] Requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK, because this one it was recently submitted electronically on [PII].
[AGENT][NEUTRAL] To who? To APL?
[CUSTOMER][NEUTRAL] To you guys, yes.
[AGENT][NEUTRAL] Oh, this is the only claim that we've received um in this amount, but you said electronically, yeah, we haven't received anything since [PII] for this member.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] That's the date of service, but in terms of incoming claims, the last one was [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So we didn't receive your claim in January.
[CUSTOMER][NEUTRAL] OK, what is your fax number?
[AGENT][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, perfect. OK, I would send the claim and the primary insurance COP. What would be the reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name and today's date, and that's [PII], first [PII] to my last name is [PII].
[CUSTOMER][POSITIVE] OK thank you very much appreciate it.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No no that was all.
[AGENT][POSITIVE] All right. Well, thanks so much for calling APL Genesis. I hope you have a great week.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you bye bye.