AccountId: 011433970860
ContactId: 158c6c56-d545-4d04-a914-d8725194f625
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290420 ms
Total Talk Time (AGENT): 90256 ms
Total Talk Time (CUSTOMER): 134448 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/158c6c56-d545-4d04-a914-d8725194f625_20250211T19:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there, my name's [PII], and I'm calling in regards to follow up for a claim that we submitted um back in [PII], um, and I'm trying to see, it says that the insurance company accepted it, but we haven't heard anything else, um, so I was just looking to see if there's uh an ETA on an EOB.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um, first, could I get a good um callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, her number is 4 as in Dog 476885-49.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Um, if you have the social, I can look it up that way or either name and date of birth.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me get her card out here sorry.
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] Um, that's all I have is her employee ID, um, and the patient's actually the child.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, so I don't have her social.
[AGENT][NEUTRAL] OK. Well, I'll try to look him up by name. What's the last name?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] First name, [PII]
[CUSTOMER][NEUTRAL] And her mom's name is [PII], who is the insured.
[AGENT][NEUTRAL] And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, I found them in our system. Would you like the policy number?
[CUSTOMER][POSITIVE] Yes, that would be great.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] And the policy number is 02.
[AGENT][NEUTRAL] 55
[AGENT][NEUTRAL] 0155.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the date of service and the bill charges on the claim?
[CUSTOMER][NEUTRAL] It is um [PII].
[CUSTOMER][NEUTRAL] And the charge was for $138 for CPT code 99213.
[AGENT][NEUTRAL] OK. I'm actually not showing that claim on file for [PII]. Um, how was it submitted?
[CUSTOMER][NEUTRAL] Um, electronically.
[AGENT][NEUTRAL] What pay ID did you guys use?
[CUSTOMER][NEUTRAL] Um, again 645-556.
[AGENT][NEUTRAL] Oh yeah, that's the correct payer ID um claims can also be mailed in.
[CUSTOMER][NEUTRAL] OK, so, um, I'm wondering because we have her subscriber.
[CUSTOMER][NEUTRAL] Number as the that um D 476-88549 that I gave you originally so I'm just wondering if maybe I should change it to the 02550155 policy number that you gave me. Would that be helpful?
[AGENT][NEUTRAL] Um
[AGENT][POSITIVE] Yes, ma'am. That'll work also.
[CUSTOMER][NEUTRAL] OK, so, um, is there anything else I would need to include with that?
[AGENT][NEUTRAL] Um, no, ma'am. We'll just need the client. Mhm.
[CUSTOMER][NEUTRAL] And is there a
[CUSTOMER][NEUTRAL] OK, is there a group number or anything for her specific?
[CUSTOMER][NEUTRAL] Policy
[AGENT][NEUTRAL] Um, the, the group number is 70084.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and um it's going to go to IMA is that correct?
[AGENT][POSITIVE] That's correct. That's will process the claim.
[CUSTOMER][POSITIVE] OK perfect well I'm gonna get this information updated and I thank you so much for your time. Is there a call reference for this?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] and my last initial is [PII] and today's date is the reference number. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] No, ma'am. That'll be all. Thank you so much for your time.
[AGENT][POSITIVE] Oh, no problem, [PII]. I thank you for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] You too thank you bye bye.