AccountId: 011433970860
ContactId: 111ccc31-195e-4948-892d-67293bd26684
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282720 ms
Total Talk Time (AGENT): 75859 ms
Total Talk Time (CUSTOMER): 120272 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/111ccc31-195e-4948-892d-67293bd26684_20250312T12:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, yes, ma'am, trying to get some more information on a, um, patient's eligibility.
[AGENT][NEUTRAL] And your name?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] excuse me, my name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] OK, so I, I see on their ID there's a policy cert number and there's a medical ID number.
[AGENT][NEUTRAL] Mhm. That's it.
[CUSTOMER][NEUTRAL] The policy start number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1,303,310.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, and I'm sorry, what's the nature of your call, [PII]?
[CUSTOMER][NEUTRAL] Um, I'm checking, um, the eligibility, um, for the, for, for the member.
[AGENT][NEUTRAL] OK, and so are you calling on behalf of the provider's office?
[CUSTOMER][NEUTRAL] Uh yes ma'am.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's gonna know how you pronounce this, it's.
[CUSTOMER][NEUTRAL] I, I, I'm gonna spell his first name for you. It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Last name [PII].
[CUSTOMER][NEUTRAL] The date of birth is going to be [PII].
[AGENT][POSITIVE] Alright, thank you for that information and I have the effective date for you. It is [PII].
[AGENT][NEUTRAL] [PII] and I do show the policy is active at this time and did you have any other questions?
[CUSTOMER][NEUTRAL] OK, so, um, yes, so when we, uh.
[CUSTOMER][NEUTRAL] Submit our claims.
[CUSTOMER][NEUTRAL] Do we submit that with the policy number or the medical ID number?
[AGENT][NEUTRAL] The policy number that you gave me.
[CUSTOMER][NEUTRAL] Ah, OK, that's we, that's why I can't find it. We submitted it with a um.
[CUSTOMER][NEUTRAL] The uh medical ID for some reason.
[AGENT][NEUTRAL] What's the data service?
[CUSTOMER][NEUTRAL] The data service is going to be [PII].
[AGENT][NEUTRAL] And for how much?
[CUSTOMER][NEUTRAL] $965.
[AGENT][NEUTRAL] When did you send it?
[CUSTOMER][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] The date on the claim is [PII]. Let me check our note.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, yeah, that's when it was that was submitted on the [PII].
[CUSTOMER][NEUTRAL] Of February.
[AGENT][NEUTRAL] Yeah, we've not received that one yet.
[CUSTOMER][NEUTRAL] Alright, um,
[AGENT][NEUTRAL] The claim yet?
[CUSTOMER][NEUTRAL] So it looks like it was mailed to [PII].
[AGENT][POSITIVE] Mhm that is correct.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] So we should be receiving it shortly.
[CUSTOMER][NEUTRAL] So we shouldn't rebill it with the policy number or with that number.
[AGENT][NEUTRAL] It, it's up to you. It's up to you.
[AGENT][NEUTRAL] Cause you said that you put the other number on the other one, I went to resubmit it.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] With the correct policy.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Only showing where we submitted it the one time.
[AGENT][NEUTRAL] To the member ID number that starts with a D.
[CUSTOMER][NEUTRAL] Uh yes ma'am.
[AGENT][NEUTRAL] Right, so I'm saying if you want to submit it with the number that I that you gave me the 130 number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. If we receive it twice, that's OK.
[CUSTOMER][NEUTRAL] OK, we'll get this over to billing if someone else gets the claim and, and works with then you know they'll they'll be looking for the wrong number.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Alright, um, if I get a call reference number. I do appreciate your help.
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII].
[AGENT][NEUTRAL] ONYA first initial last name is [PII].
[CUSTOMER][POSITIVE] Alright, well I really do appreciate your help today. Thank you so much.
[AGENT][POSITIVE] Oh, you're welcome and thank you for calling APR [PII]. Have a good day.
[CUSTOMER][POSITIVE] Alright thank you too bye.