AccountId: 011433970860
ContactId: 27eb64fa-4148-4ab5-a96e-03c1f1e680a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453730 ms
Total Talk Time (AGENT): 160052 ms
Total Talk Time (CUSTOMER): 105415 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/27eb64fa-4148-4ab5-a96e-03c1f1e680a0_20250425T14:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] Mo calling from Saint Francis Hospital checking on on claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the claim status, and give me a moment. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, that would be [PII] and it's a direct line.
[AGENT][NEUTRAL] And thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, that would be D as in Delta 46,801,630.
[AGENT][NEUTRAL] Thank you. And do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Um, I'm sorry, no.
[AGENT][NEUTRAL] OK, um, because that the number is for 90 Degree benefits, which is a different company. Um, I can also search the policy with the member's first and last name or full social.
[CUSTOMER][NEUTRAL] Um, yes, member's name would be.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, hold on one moment. That was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and then just for my notes, can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] Yes, my name is spelled as [PII]. And my initial would be [PII].
[AGENT][NEUTRAL] Thank you for that. I'm just waiting for the policies to populate here. Hold on one moment.
[AGENT][NEUTRAL] And you said his first name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And does the member have a middle initial?
[AGENT][NEUTRAL] Because there's a few [PII].
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] Yes, they do have a middle name that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Let me ask you this, do you have their group number?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] What's the group number? It may be easier to look through the group because there's a, there's quite a few.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, is it
[CUSTOMER][NEUTRAL] Yes, the group number is 9468.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] That's not pulling up an active policy. Do you have the member's full social?
[CUSTOMER][NEUTRAL] Yes, I do have uh the social number that is [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] I'm waiting for the policies to come up here. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And is this for his medical or dental policy?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] Medical, OK.
[AGENT][NEUTRAL] I believe I just found it. I'm waiting for it to come up so I can see the date of birth and confirm with you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what is um [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, OK, this is him. Um, so thank you for verifying and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing um the policy number is 243-7783.
[AGENT][NEUTRAL] And may I have the date of service for the claim and the total bills?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, the date of service would be.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it's for the bill amount, $2,872.28.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, so I'm not showing that there's any claims on file for [PII], um, but we don't have a timely filing limit, so you can still file the claim if you like, um, because the policy was active on the data service. It's been active since [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] The claim mailing address and the pay ID.
[AGENT][NEUTRAL] Say that one more time, you said the claims mailing address and payer ID?
[CUSTOMER][NEUTRAL] Yes, to some of the claim.
[AGENT][NEUTRAL] OK, so the mailing address is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And you said you needed the pay ID as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][POSITIVE] Thank you so much. And uh may I, may I also know the timely filing limit?
[AGENT][NEUTRAL] There is not, um, there's none. As long as the policy is active on the data service, you can file it any time.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And can I get a reference number for our call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] And uh thank you so much for your assistance. Have a great day.
[AGENT][POSITIVE] Thank you, [PII]. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Um, no, thank you.
[AGENT][POSITIVE] All right, well, thank you so much for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye bye.