AccountId: 011433970860
ContactId: 2b252bfc-afce-4b52-a7ce-c185cb10a815
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227720 ms
Total Talk Time (AGENT): 117335 ms
Total Talk Time (CUSTOMER): 106902 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/2b252bfc-afce-4b52-a7ce-c185cb10a815_20250307T16:02_UTC.wav
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[AGENT][NEUTRAL] For calling AP, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, [PII]. I need to follow up on some claims for a patient.
[AGENT][NEUTRAL] Sure, I can check those claims for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Call back number from you in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII] and my extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] I do 02273427.
[AGENT][NEUTRAL] All right. And then, uh, what was the name and date of birth for the insured, please?
[CUSTOMER][NEUTRAL] It's for [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. Uh, and you said we had a few claims to look at. Are they all for the same member?
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] OK, OK, uh, what was the, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Yeah, no, I was gonna say the first two you paid, but then everything after that didn't, so I guess that's just trying to follow up on why.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure, um, what's the date of service?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In the amount of 290.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] I am not showing that we received, oh well, that was 24. Give me just a moment.
[AGENT][NEUTRAL] Oh, that's probably going to be why. Um, so his policy, uh, terminated [PII].
[CUSTOMER][NEUTRAL] Oh, really? OK.
[AGENT][NEUTRAL] And I am only seeing, yes, um, I'm only seeing one claim that we've received for him uh that was the date of service was [PII] that's the only claim I have on file for him.
[CUSTOMER][NEUTRAL] Oh really, cause you got paid 919 and 923.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, OK, so,
[AGENT][NEUTRAL] Was this, OK, I have to ask [PII]. I'm sorry, this was this for dental?
[CUSTOMER][NEUTRAL] No, this is for medical.
[AGENT][NEUTRAL] That would explain it too. So the policy number you gave me was the dental policy.
[CUSTOMER][NEUTRAL] Oh, there's that, there's.
[CUSTOMER][NEUTRAL] It is. I, I'm looking at the card now and there's a slash and someone hand wrote in a number for medical.
[AGENT][NEUTRAL] Uh-huh. OK. Well, let's get the medical. I think I've got it. Hang on. Um.
[CUSTOMER][NEUTRAL] OK, let me give you a different number.
[AGENT][NEUTRAL] Yes, I do have the medical now his medical also terminated [PII] and for this policy, [PII], I'm actually unable to view claim information. Um, it is handled through, uh, they're called web TPA. I can give you their phone number, um, and then I could transfer you if you'd like to see if they've at least received those claims.
[CUSTOMER][NEUTRAL] Well, like I said, I know the first two in September you guys paid, but if you're saying that the insurance term on 01, that's the reason you guys didn't pay all these October claims that I have sitting out here. Um, so it looks like the patient may have another insurance as well, so, um, I'm gonna try to reach out to them to see, um.
[AGENT][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You know, because it, I mean, it, yeah, yeah, so, right, right, yeah, so, um, but that, I mean like I said now I know why nothing came through on those. So um can I get a, can I get a reference number for today's call?
[AGENT][NEUTRAL] Who they're active, yeah, or who was active at that time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There we go. Yes, ma'am.
[AGENT][NEUTRAL] Sure, it would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Nope, that was it. I appreciate your help.
[AGENT][POSITIVE] Alright, of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye bye.