AccountId: 011433970860
ContactId: 104fcabb-69c8-4d59-9d9b-619e779e4426
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 601179 ms
Total Talk Time (AGENT): 178473 ms
Total Talk Time (CUSTOMER): 206977 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/104fcabb-69c8-4d59-9d9b-619e779e4426_20250428T17:06_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 provider's office to know the claim status. Could you please help me with that?
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Yeah one.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, the numbers policy number 2444488.
[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] Yeah, my first name is uh [PII] and the first name is [PII]. And the date of birth is [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 for the claim and the total bills?
[CUSTOMER][NEUTRAL] Yeah, the date of service is gonna be just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] Yeah, the bill amount uh $1880.
[CUSTOMER][NEUTRAL] I can imagine.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] I'm doing the same.
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold while I locate the claim?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oops.
[AGENT][NEUTRAL] OK, what's the 1st 1, 940.
[AGENT][NEUTRAL] OK, wait, I'm in a 35. I need 3,347,940.
[AGENT][NEUTRAL] Oh wait, that's not what I'm looking for. I'm trying to see the total bill, so I know what's what.
[AGENT][NEUTRAL] OK, wait, so that's 407.
[AGENT][NEUTRAL] 729 729.
[AGENT][NEUTRAL] 753.
[AGENT][NEUTRAL] OK, I don't think we have this.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] 870 is a dupe of what?
[AGENT][NEUTRAL] But what's it a dupe of 729?
[AGENT][NEUTRAL] Wait a minute.
[AGENT][NEUTRAL] So 99219.
[AGENT][NEUTRAL] So then you gotta go back to see if that's what that code is on 870.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 9 to 98.
[AGENT][NEUTRAL] No, that's not on here. What is this? Oh.
[AGENT][NEGATIVE] All, all of them is in a dupe though. Only this code is.
[AGENT][NEUTRAL] Either way it goes.
[AGENT][NEUTRAL] Hello, [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. Um, is there another total bill that can be on this claim, or is it only $1880?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, $1880.
[AGENT][NEUTRAL] OK, so if that's the case, then we do not have a claim on file for that total bill. What's the name of your provider?
[CUSTOMER][NEUTRAL] OK, so that.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Yeah, the provider's name is, just a moment, uh, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said, wait, can you repeat that for me, please?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, so no, we don't have a claim on file from your provider, but there's no timely filing, so you can submit the claim at any time um because the claim, the policy was active on your data service.
[CUSTOMER][NEUTRAL] I'm just trying to
[CUSTOMER][NEUTRAL] Have.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] I like.
[CUSTOMER][NEUTRAL] So we should uh resubmit the claim once again.
[AGENT][NEUTRAL] Yes, you'll have to submit it because we have not received it.
[CUSTOMER][NEUTRAL] Just a moment, ma'am. Uh, could you please wait for uh
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Did you.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Wait a moment, please, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just a moment, uh, I was checking on this, uh.
[CUSTOMER][NEUTRAL] Yeah, ma'am. Uh, can you please check uh on date which, uh, [PII]?
[CUSTOMER][NEUTRAL] Oh please check on the date. The claim was submitted or not.
[AGENT][NEUTRAL] So it doesn't matter when it was submitted, the date of service, all the claims received with this date of service have populated. We do not have a claim from your provider or the total bill of 1880. However, you can file the claim if you like.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, OK, ma'am. Um.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, can you please check with the uh facility address, I mean facility name?
[CUSTOMER][NEUTRAL] The last one.
[AGENT][NEUTRAL] There's no claim on file for your claim, sir.
[CUSTOMER][NEUTRAL] There's no claim on file for you.
[AGENT][NEUTRAL] When I put in the date, any claim that's there for that date will come up.
[AGENT][NEUTRAL] There's no claim here for your total bills. We only have 3 claims for that day, and they're all different providers from your provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can you spell your name, please?
[AGENT][NEUTRAL] Yes, my name is [PII] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Call reference number?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name and today's date.
[CUSTOMER][NEUTRAL] Can I provide it?
[AGENT][NEUTRAL] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much for valuable information and thank you.
[AGENT][POSITIVE] You're welcome, [PII] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] So I need to submit, so yeah, so need to submit the uh resubmit the claim once again, is it right?
[AGENT][NEUTRAL] Yes, you need to submit the claim because we have not received it. We have not received it.
[CUSTOMER][POSITIVE] OK, no problem. Thank you, thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and I hope you have a good day.
[CUSTOMER][NEUTRAL] Yeah, bye. Bye bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] get.
[CUSTOMER][NEUTRAL] Hi, hi, this is [PII]. I'm calling to you and the claims department number.
[CUSTOMER][NEUTRAL] Uh, uh, hello this is
[AGENT][NEUTRAL] Yes, I'm still here.