AccountId: 011433970860
ContactId: 25c1cfb2-1861-4d20-bd7b-85a755cb0105
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 384559 ms
Total Talk Time (AGENT): 120883 ms
Total Talk Time (CUSTOMER): 141074 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/25c1cfb2-1861-4d20-bd7b-85a755cb0105_20250203T21:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling to check on a claim.
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you today, [PII]. What's the patient's policy number?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] The member's policy ID will be 01659701 M like Mike L Lima 7.
[AGENT][POSITIVE] Thank you and do you have a good call back number?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line. And how do you spell out your name?
[AGENT][NEUTRAL] My name is spelled [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh-huh. What is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The number is, the first name is [PII] as [PII] as in [PII], A as in Alpha, N as in November. That's a space and then C like Charlie.
[CUSTOMER][NEUTRAL] And then the last name is [PII], and the member's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Data service?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] [PII] for the charge $10,742 even.
[AGENT][POSITIVE] Alright thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] I'm not showing any claims on file. Data service [PII].
[CUSTOMER][NEUTRAL] All right, just allow me one quick moment.
[CUSTOMER][NEUTRAL] Uh, are you able to find the policies active for the member?
[AGENT][NEUTRAL] Yes, it's a different policy number that's active. Would you like that?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] The active policy is 02505740.
[AGENT][NEUTRAL] The effective date is [PII].
[CUSTOMER][NEUTRAL] And do you have a term date?
[AGENT][NEUTRAL] No term date.
[CUSTOMER][NEUTRAL] And the policy is still active, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right, thank you. And I could see previously we sent the claim through paper and for my documentation, could you please help me with your mailing address?
[AGENT][NEUTRAL] Claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. Thank you so much. And for my documentation, are you able to also help me with your payer ID and the fax number, please?
[AGENT][NEUTRAL] Mhm. Payer ID is 60801.
[AGENT][NEUTRAL] And the fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] Perfect. Thank you. And may I have the time frame to file a claim?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][POSITIVE] Thank you. And uh could you please help me with the member group name and group number?
[AGENT][POSITIVE] Oh yeah, absolutely. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, the group number is 16944.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the name is City of [PII].
[CUSTOMER][NEUTRAL] Could you please spell out the first word of the group name?
[AGENT][NEUTRAL] City, [PII], yeah, [PII].
[CUSTOMER][NEUTRAL] City. All right.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh um
[CUSTOMER][NEUTRAL] Uh, I got it. Thank you. And it's, uh, could you please uh help me with the full, uh, group name, City?
[AGENT][NEUTRAL] Of, [PII].
[AGENT][NEUTRAL] And then [PII], that is spelled [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you so much for spelling that out. And could you also please help me with the ma plan type?
[AGENT][NEUTRAL] Uh, this is their secondary meddling plan.
[CUSTOMER][POSITIVE] Alright, thank you. Thank you so much for this information.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right, and
[CUSTOMER][NEUTRAL] That's it for this number. And can I have a reference number for a call?
[AGENT][NEUTRAL] [PII] references my name with my last initial in today's date. The last initial to my name is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you. Thank you, sir, for your assistance. Have a great day. Bye-bye.
[AGENT][NEUTRAL] You too bye bye.