AccountId: 011433970860
ContactId: 1baf4ef7-f2b0-4c7f-8bd8-302dde0aad53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294489 ms
Total Talk Time (AGENT): 122258 ms
Total Talk Time (CUSTOMER): 67894 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/1baf4ef7-f2b0-4c7f-8bd8-302dde0aad53_20250506T12:36_UTC.wav
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[AGENT][NEUTRAL] Morning thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from uh Roper Saint Francis Physicians Network. I was calling to get assistance with the members plan and um get an updated status on their claim.
[AGENT][NEUTRAL] OK, when you say an updated status, Maine, are you trying to verify eligibility to see if it is active?
[CUSTOMER][NEUTRAL] Yes, and then I was trying to see if their claim has been received.
[AGENT][NEUTRAL] OK, so you're needing claim status.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the member's policy number.
[CUSTOMER][NEUTRAL] 40, well, give me one second.
[AGENT][NEUTRAL] I was gonna say that's not our number.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] Yeah, 02430834.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] And any information that is provided would be a verification of benefits, mainly and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Last name [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, so I do show that he had been the excuse me, the spouse of the subscriber on this policy as far as eligibility. The effective date on the plan was [PII], and it turned on [PII].
[AGENT][NEUTRAL] And then what is the date of service that you're inquiring about?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. And total bills amount?
[CUSTOMER][NEUTRAL] $328.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for him for data service of [PII].
[CUSTOMER][NEUTRAL] OK. Um, can you confirm?
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you confirm the address that I'm uh supposed to be sending that claim to?
[AGENT][NEUTRAL] Yes, the claims would go to IMA at [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the payer ID is 64556.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then [PII], one last thing, yes ma'am, once the claim has been received and processed, we do have a portal in which you should also be able to check claim status and the website for our portal is located at secured.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And is there
[CUSTOMER][NEUTRAL] OK, I do see that.
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] Yes. Uh-huh.
[CUSTOMER][NEUTRAL] Um, can I get your name, please?
[AGENT][NEUTRAL] Again, my name is [PII], and my name in today's date will be your call reference number if you need one.
[CUSTOMER][POSITIVE] OK, thank you so much you have a good day.
[AGENT][POSITIVE] Well, you're very welcome and I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you.