AccountId: 011433970860
ContactId: 285cda4b-a9ed-4d2a-93c5-e330eeec694d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 763719 ms
Total Talk Time (AGENT): 214546 ms
Total Talk Time (CUSTOMER): 168446 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/285cda4b-a9ed-4d2a-93c5-e330eeec694d_20250212T19:16_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Oh sorry, I was calling to check on a claim for a patient.
[AGENT][POSITIVE] Can I have your name and a callback number and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. Did you say the tax ID?
[AGENT][NEUTRAL] The callback number just in case the call is disconnected?
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] 254559
[CUSTOMER][NEUTRAL] 2122.
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] What is the policy number of the member that you're inquiring claim status for?
[CUSTOMER][NEUTRAL] It is 449-745-585.
[AGENT][NEUTRAL] Is this a policy number or something else because it's too long to be a policy number.
[CUSTOMER][NEUTRAL] I maybe that's her social.
[AGENT][NEUTRAL] Could you repeat it cause I, I was actually looking for a policy number.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What is this member's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. So let me give you the correct policy number for future reference, even if you submitted the claim, call to check the status of the claim. It is 726759. That's 726-759.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what's the date of service that you're inquiring claim status for?
[CUSTOMER][NEUTRAL] It was.
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] I like
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Not showing the claim on file. We haven't received the claim for this individual since [PII].
[CUSTOMER][NEUTRAL] OK, let me, I'm not sure.
[AGENT][NEUTRAL] And you said your date of service was [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am, um, is the payer ID 60?
[AGENT][NEUTRAL] What was the date in October?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII] sorry.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] How weird um how.
[AGENT][NEUTRAL] We have a fax number.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, I'm, I'm telling you that we have a fax number if you want to send it over by fax.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Um, yeah, go ahead. What is it?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] We need
[AGENT][NEUTRAL] 942-3 that's [PII] and that payer ID was 60801.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, and I have our group number is 11406, is that right?
[AGENT][NEUTRAL] One moment.
[AGENT][POSITIVE] I can check it for you.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what did you say her group number was?
[CUSTOMER][NEUTRAL] 11406.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So when you guys submitted the claim, what did you use? Did you use her social? Did you use the policy number? But they still would have been able to look her up though with her name.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I think that
[CUSTOMER][NEUTRAL] I think that's her social, honestly, I'm not sure what that is, um.
[AGENT][NEUTRAL] Um, but the policy number.
[CUSTOMER][NEUTRAL] It seems like we've had an update and it's kind of changed like all the information that we had before um.
[AGENT][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] And this looks kind of it looks kind of weird is the street address [PII]?
[CUSTOMER][NEUTRAL] For mailing address for claims?
[AGENT][NEUTRAL] Oh no, this, uh uh, that's been changed years ago. So the the mailing address is.
[CUSTOMER][NEUTRAL] Yeah it looks like it like.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] What were you about to say?
[CUSTOMER][NEUTRAL] I was gonna say it looks like everything kind of went back to like the old like old system or something.
[AGENT][NEUTRAL] The old stuff. Oh.
[AGENT][NEUTRAL] It was the mailing address should be [PII]. That's [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] In
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I can't even spell [PII] today. OK, I've got it, um.
[AGENT][POSITIVE] It's OK [PII]
[CUSTOMER][NEUTRAL] Oh I got it. You're good. Um, I have one other patient that's APL that I might be the same problem and it looks like I have a weird.
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] I have 00681218.
[AGENT][NEUTRAL] That's the policy number. What is that member's name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Yeah [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Was that the right policy number for him?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Oh, that's good.
[AGENT][NEUTRAL] And what is the date of service
[CUSTOMER][NEUTRAL] Um, do you have?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] It hasn't been as long as [PII]. His was [PII].
[AGENT][NEUTRAL] So we have a claim on file for him.
[CUSTOMER][NEUTRAL] OK, has it been processed or still waiting?
[AGENT][NEUTRAL] It was processed [PII].
[CUSTOMER][NEUTRAL] Oh, was that a check?
[AGENT][NEUTRAL] Check number
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, we haven't got that one yet.
[AGENT][NEUTRAL] The check number is.
[AGENT][NEUTRAL] 2021814
[CUSTOMER][NEUTRAL] Is there a way to do a stop payment on it and reissue it?
[AGENT][NEUTRAL] Um, I can check that we have to verify if it's been cashed or not through the finance department, and once it comes back, then they'll be able to verify if it has, um, if we could, if it hadn't been cashed then they're gonna verify that and then they're gonna send the information over to us in the claims department and we'll be able to process the claim. I'll place you on a brief hold while I contact the while I submit that information over to the finance department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Cool.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] I'll be very thank you.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding, [PII]. What is the fax number if the check has been cashed, then we send you a copy of it.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Yes ma'am, was it cash?
[AGENT][NEUTRAL] Well, it's not, it's not gonna take, no, it's gonna take a while. It's gonna take a couple of days for them to verify. So is there anything else that I can assist you with today? So I've submitted that information over to them, is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Or you have don't know yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] No ma'am, that's it.
[AGENT][POSITIVE] Alright, [PII], well, thanks for calling APL and you have a great day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thanks. Goodbye.
[CUSTOMER][NEUTRAL] Mhm bye.