AccountId: 011433970860
ContactId: 22ac438b-14bf-43a5-93a9-bf1111aaa4b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 590739 ms
Total Talk Time (AGENT): 135114 ms
Total Talk Time (CUSTOMER): 195398 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/22ac438b-14bf-43a5-93a9-bf1111aaa4b2_20250403T20:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII].
[CUSTOMER][NEUTRAL] And I have 2 members and I wanted to know the claim status.
[AGENT][NEUTRAL] On two different patients?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. What's the policy number?
[CUSTOMER][NEUTRAL] 236-3909
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Give me that again.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, your area code is [PII].
[CUSTOMER][NEUTRAL] Mm, yes.
[AGENT][NEUTRAL] And you gave me [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so [PII] is your phone number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and if you can verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Your patient's name is uh
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. That's it. And date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thanks for verifying that for me, [PII], and we're checking a claim status for what day?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and what's the total bill amount?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Total bill amount would be.
[CUSTOMER][NEUTRAL] $218.23. And as I can see your primary insurance already paid.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And there is some coinsurance, so that's why I called.
[AGENT][NEUTRAL] OK, I'm not showing a claim on file for [PII].
[AGENT][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Was it just recently submitted?
[CUSTOMER][NEUTRAL] Yeah, actually, we submitted on.
[CUSTOMER][NEUTRAL] We submitted on [PII].
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] Through paper.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I don't show that we've received that um, what address was it mailed to?
[CUSTOMER][NEUTRAL] Sorry, ma'am. I don't have this information. So, please tell me, uh, patient, patient what active on the, the state of service?
[AGENT][NEUTRAL] The policy effective date is [PII]. The policy is active.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm. And the date?
[AGENT][NEUTRAL] The policy is active.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] And the termination date.
[AGENT][NEUTRAL] It's not termed, it's active.
[CUSTOMER][NEUTRAL] OK, No termination.
[CUSTOMER][NEUTRAL] And can you provide me your ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801 and uh mailing address?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 248.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And uh may I know your name?
[AGENT][NEUTRAL] Uh my name is, you'll use my name in today's status reference, [PII] First initial last name is [PII].
[CUSTOMER][NEUTRAL] For my reference.
[CUSTOMER][NEUTRAL] OK, ma'am. I have uh the date of service for this number.
[AGENT][NEUTRAL] Is it a different policy number or the same policy number?
[CUSTOMER][NEUTRAL] 22 other data service.
[CUSTOMER][NEUTRAL] No, same number but different uh data service.
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the amount.
[CUSTOMER][NEUTRAL] Mm, one moment.
[CUSTOMER][NEUTRAL] Yes, the total the total charge amount is uh
[CUSTOMER][NEUTRAL] 10 $1,293.63.
[CUSTOMER][NEUTRAL] Got it?
[AGENT][NEUTRAL] Yes. You said 1,293.63?
[CUSTOMER][NEUTRAL] Mm, yes.
[AGENT][NEUTRAL] And what are the procedure codes on the claim?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, 52356 and the other one is
[CUSTOMER][NEUTRAL] 74,420 and primary payrolls already paid.
[AGENT][NEUTRAL] OK, I'm not showing that date of service on file either.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And you can also check status, uh, online at [PII].
[CUSTOMER][NEGATIVE] Claim not.
[CUSTOMER][NEUTRAL] One moment. Where?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Secured
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] AM [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Keyword. [PII], correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And call reference would be?
[CUSTOMER][NEUTRAL] Your name and today's date.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So today's date is [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] Uh, and, and I have one more date of service.
[AGENT][NEUTRAL] Is it for the same person?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you have any more for this person?
[CUSTOMER][NEUTRAL] [PII], no, that's it.
[AGENT][NEUTRAL] OK, go, go ahead.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the amount.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, so the total amount is $56368.43.
[AGENT][NEUTRAL] OK, 568 43 or 56848?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] 568.43.
[AGENT][NEUTRAL] 43, OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, I don't show that data service on file either for [PII].
[CUSTOMER][NEUTRAL] Yeah I would do the same.
[AGENT][NEUTRAL] Do not show that claim on file for [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] No, thank you
[AGENT][NEUTRAL] Did you have any other questions, [PII]?