AccountId: 011433970860
ContactId: 1aba1892-7ec0-4c3d-8f84-73405a2d6afb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 337540 ms
Total Talk Time (AGENT): 119053 ms
Total Talk Time (CUSTOMER): 163298 ms
Interruptions: 6
Overall Sentiment: AGENT=0, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/1aba1892-7ec0-4c3d-8f84-73405a2d6afb_20250424T20:42_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]. Can you please help me with the, sorry, this is [PII] calling from provide office. Can you please help me with the claim status?
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with the claim status, [PII], and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mm, yes, you can have uh
[CUSTOMER][NEUTRAL] And it is um
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] As of now I have one claim.
[AGENT][NEUTRAL] And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes you can have, um.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] So it is the insured ID is RX0 RXO 2108285. I repeat, RXO 2108285.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so, uh, the APL policy number starts with a 01 or 02. It may have an ML 7 or 8 at the end.
[CUSTOMER][NEUTRAL] [PII] is.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEGATIVE] Sorry, I didn't get you. Please come again.
[AGENT][NEUTRAL] What's the member's first and last name?
[CUSTOMER][NEUTRAL] Um, it is, uh, last name is [PII], and the first name is [PII].
[AGENT][NEUTRAL] So the APL policy number starts with a 01 or 02. It may have an ML 7 or 8 at the end. Do you have a number that matches that format? This is not an APL policy number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Can you please try with the group number I can provide you?
[AGENT][NEUTRAL] Sure, what's the group number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It is 012001.
[AGENT][NEUTRAL] 012001.
[CUSTOMER][NEUTRAL] Yes, it is
[AGENT][NEUTRAL] What's the member's first and last name?
[CUSTOMER][NEUTRAL] Uh, it is, uh, last name is [PII]. First name is [PII]. Can I spell it? Are you good enough?
[AGENT][NEUTRAL] I'm [PII] Can you spell the last name for me?
[CUSTOMER][NEUTRAL] Uh last name is uh [PII].
[AGENT][NEUTRAL] [PII],
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] So, we don't have a member with that last uh
[AGENT][NEUTRAL] Last name. Do you have their full social? I can try to search with the social.
[CUSTOMER][NEUTRAL] Uh, I can provide you the last four digits of SSN because I don't have the full SSN number.
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Um, we can't search for just the last 4. do you have a copy of the member's ID card?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, I do not have.
[AGENT][NEUTRAL] OK. So for this one, we're gonna need some more information so we're able to pull. Um there's no policy with the member's name. The policy number is not an APL policy number, and the group number is not an APL group number.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, can you, um, like, uh, can you find the, uh, member ID with the patient details so that I can, it can, uh, be helpful for me.
[AGENT][NEGATIVE] There is no policy here for your member. So you have to reach out to the member to get more information because with their first and last name, nothing came up.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] We don't have their social.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] The policy number that you provided is not an APL policy number, nor is the group number, so we don't have enough information and with what we have, there's nothing here matching it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, I'm asking uh if I provide you the patient name, date of birth, can you pull the patient's uh insurance ID?
[AGENT][NEGATIVE] You've already given me the patient's name and nothing came up. That's what I'm saying. There's no policy here with this name.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So the other, the only other option would be to search with the full social or a true APL policy number.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I know.
[CUSTOMER][POSITIVE] I'm good enough. Thank you for your assistance. Have a good day. Bye.
[AGENT][POSITIVE] All right, [PII], well, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Yeah.