AccountId: 011433970860
ContactId: 0ab899c2-089b-41a4-b417-992c49b05fdf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 441220 ms
Total Talk Time (AGENT): 141713 ms
Total Talk Time (CUSTOMER): 217491 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/0ab899c2-089b-41a4-b417-992c49b05fdf_20250319T16:14_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] calling from the provider's office regarding claims information. How are you doing today?
[AGENT][POSITIVE] I'm great, thanks for asking, [PII]. How are you?
[CUSTOMER][NEUTRAL] I'm good, thanks for asking. Before I proceed and informed that the call is being recorded for the quality and training purposes. Would you like to continue recording.
[AGENT][POSITIVE] Sure, [PII]. Can I have a callback number for you and that policy number and I'll be able to assist you with that claim status.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure. The callback number is [PII]. It is direct call line and the policy number is
[CUSTOMER][NEUTRAL] 01369754 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is that member's name and date of birth that you're checking claim status for?
[CUSTOMER][NEUTRAL] Sure, sure, the member's name is uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, give me that policy number again because that's not what we're pulling up.
[CUSTOMER][NEUTRAL] Yeah it is uh.
[CUSTOMER][NEUTRAL] Policy, once I repeat once again, the policy number.
[CUSTOMER][NEUTRAL] It is 01369754 ML8 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] And spell the member's first name?
[CUSTOMER][NEUTRAL] The first name is uh [PII].
[AGENT][NEUTRAL] And what's the member's date of birth?
[CUSTOMER][NEUTRAL] Sure, it is uh [PII].
[AGENT][NEUTRAL] I'm not showing that member in the the date of birth on file. Could you verify her date of birth? because that's not what we have on the in the system.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, one second, I will check another uh.
[CUSTOMER][NEUTRAL] Yeah. Another date it is [PII].
[AGENT][NEUTRAL] OK, so that's the correct date of birth that I have. I'm not sure who date of birth you gave me in the beginning. What is the date of service that you're checking the status status of a claim for?
[CUSTOMER][NEUTRAL] Sure, mhm. So, the date of service is uh [PII] and the bill amount is $458 458 dollars even.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] I'm not showing a claim on file for [PII].
[CUSTOMER][NEUTRAL] We have built a claim on [PII], uh.
[CUSTOMER][NEUTRAL] So till now you don't receive any claim.
[AGENT][NEUTRAL] Not for [PII], what was the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, that's correct. [PII]. There's no claim on file for the data service.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So, so there is no problem, but we have built a claim on [PII].
[AGENT][NEUTRAL] Do you have a claim number? Because I don't see a claim on file for [PII] for [PII]. And what was your name?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] Uh, we don't have the claim number. Just I need the claim status. Could you please verify the, uh, address? It is [PII]. It is correct address to bill.
[AGENT][NEUTRAL] No, that's not the correct address, so that's probably why the claim is not on file. What was your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you [PII]. So let me give you the correct claim number.
[CUSTOMER][NEUTRAL] OK. Mhm. corrected this.
[AGENT][NEUTRAL] It's called, it's addressed to American public life.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 2489.
[CUSTOMER][NEUTRAL] One second, I will check.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 0
[AGENT][NEUTRAL] [PII]. No, it's [PII].
[CUSTOMER][NEUTRAL] It is not
[CUSTOMER][NEUTRAL] OK, 248,950. OK, I got it.
[CUSTOMER][NEUTRAL] OK, it is 2489.
[CUSTOMER][NEUTRAL] 50.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, I got it. Could you please spell out your name for me your name?
[AGENT][NEUTRAL] So could you repeat the mailing address so that way we can receive the claim when you actually send it this time?
[CUSTOMER][NEUTRAL] OK, OK, sure.
[CUSTOMER][NEUTRAL] It is [PII] [PII] ZIP code [PII].
[AGENT][NEUTRAL] No, sir. So it's [PII] [PII] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]. That's [PII] is the zip code.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And my name is [PII]. Today's date is a reference, Jack, because we don't provide reference numbers, unfortunately.
[CUSTOMER][NEUTRAL] OK, sure, um, I have one more claim. Could you please help me with that? Are you ready for the next member ID?
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][POSITIVE] One moment, it is loading. Thank you for cooperating.
[CUSTOMER][NEUTRAL] Mm mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] It is loading. Sorry for the delay.
[AGENT][POSITIVE] Sure, take your time.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I think this sort of claim was built with incorrect address, so that's the reason we did not receive any response sir. OK, I got it, um.
[CUSTOMER][NEUTRAL] I will just I want to know the eligibility of this one because it is active or not. The policy number is 02161325.
[AGENT][NEUTRAL] Can you verify that patient's name and date of birth that you requested eligibility for?
[CUSTOMER][NEUTRAL] Yeah, yeah, it is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to verify eligibility. This policy has been active since [PII] and it's currently active. Is there anything else that I can assist you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, thank you so much, uh, Sheriff, for providing information. Have a great day. Bye-bye. Stay safe.
[AGENT][POSITIVE] Thanks for calling APA. You have a great one as well, [PII]. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.