AccountId: 011433970860
ContactId: 2cd5fe0c-9294-4908-9f93-3df655580914
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214940 ms
Total Talk Time (AGENT): 91510 ms
Total Talk Time (CUSTOMER): 93610 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/2cd5fe0c-9294-4908-9f93-3df655580914_20250619T16:35_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] and my last insurance is in Mike calling from the provider side to check the claim status.
[AGENT][NEUTRAL] OK, and you said your first name is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, and you have, you're wanting to check claim status, is that also correct?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, [PII], I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you [PII] how many claims do you have to check status on today?
[CUSTOMER][NEUTRAL] Yeah, one time.
[AGENT][NEUTRAL] OK. And what is that member's policy number because I can't help you with this.
[CUSTOMER][NEGATIVE] Sorry, I couldn't get it.
[AGENT][NEUTRAL] Yes, I can help you with this. What is the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02460337 M as in Mike, L as in Lima 8.
[AGENT][POSITIVE] Thank you. One moment, please.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] And only any information provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient first name is [PII] and last name is [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] take it.
[AGENT][NEUTRAL] And what is the the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] J
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and total charge amount is $43,558.15.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] I hope you have a good one.
[AGENT][NEUTRAL] OK, and [PII], you said the total bill amount is $43,558.15 for data service [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, there is no claim on file for this member for that data service and that billed amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Now, because this is a supplemental policy, we will have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once the claim has been processed by APL Moy we do have a portal in which you should be able to check the claim status and by going to secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Yeah