AccountId: 011433970860
ContactId: 051b20f1-f661-436d-9217-027c0bb7f69f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 212289 ms
Total Talk Time (AGENT): 101022 ms
Total Talk Time (CUSTOMER): 73425 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/051b20f1-f661-436d-9217-027c0bb7f69f_20250123T21:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][POSITIVE] Good afternoon. This is [PII]. I'm calling to hopefully obtain claim status for one of our patients.
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, please?
[CUSTOMER][NEUTRAL] Uh yes, it's 022.
[CUSTOMER][NEUTRAL] 92666
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] build amount is $277 even.
[AGENT][NEUTRAL] Thank you. And that was [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me see if I can find this claim for you. And for future, you can check claim status online through our website at [PII] and that's just optional, OK? You can always call.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mm, it doesn't look like we have that claim. Let me check one more time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, there's no claims on file for that date of service.
[CUSTOMER][NEUTRAL] OK, and you said um online portal is [PII]?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK, and I, I did try to do that and I went under a new user for medical provider.
[CUSTOMER][NEUTRAL] It asked for our tax ID and also the patient account number I entered, well, I guess.
[CUSTOMER][NEUTRAL] You're saying that you don't have a claim on file. I was, that could be why.
[AGENT][NEUTRAL] Yeah, that could be why, mhm, yeah, and usually if you have another claim that we have process any other claims we have processed even if it's for a different member and you use that pay um that user number to register, um, you'll be able to see if we, if you got if you got the claim and process the claim, but if you never receive an explanation of benefits from us, then no, it's not gonna let you register unless we process the claim for that provider.
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Got you
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And do you have a reference number
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh yes, the spelling, please.
[AGENT][NEUTRAL] Yeah, sure, yes, it's [PII]. That's [PII]. Last initial [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome, [PII] and thank you for calling APL. You have a good day. Good afternoon.
[CUSTOMER][POSITIVE] All right you too thanks bye bye.
[AGENT][POSITIVE] Thank you. You're welcome. Bye bye.