AccountId: 011433970860
ContactId: 2f8038e5-7254-4088-8d8f-05077f588297
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332670 ms
Total Talk Time (AGENT): 108272 ms
Total Talk Time (CUSTOMER): 93296 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/2f8038e5-7254-4088-8d8f-05077f588297_20250523T17:56_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, is [PII]. I'm calling from Pri's office regarding claims, uh, but I couldn't catch your name. Could you please spell out your name for me?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. And sure, I can assist you with claim status. May I have the spelling of your name?
[CUSTOMER][NEUTRAL] Sure. It's Street, spells like [PII].
[AGENT][POSITIVE] Thank you and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. It's uh [PII]. It's the direct line.
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from, from my notes?
[CUSTOMER][NEUTRAL] Uh, sure, and the first name it's uh [PII].
[AGENT][NEUTRAL] They.
[AGENT][NEUTRAL] OK, and may I have the patient's policy number, Miss?
[CUSTOMER][NEUTRAL] Sure. It's 01678723 M as in Mike.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's uh [PII] and the date of birth [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, that's perfect, thank you.
[AGENT][NEUTRAL] And you said you're looking for claim status?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] And the date of service it's on uh [PII].
[AGENT][NEUTRAL] How much is the total charge?
[CUSTOMER][NEUTRAL] It's uh 3 $3,916.22.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, for future, you can check claim status online through our website at [PII] and that's just optional. Um, let me check and see if this is your claim, bear with me.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, sure.
[AGENT][NEUTRAL] Bear with me it's been processed several times.
[AGENT][NEUTRAL] Right, right.
[AGENT][NEUTRAL] OK, so it looks like the last time that we processed the claim was on [PII].
[AGENT][NEUTRAL] And it looks like it was the nice idea waiting information from the employer to confirm eligibility. So as of today, we have not received that information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, may I have your claim number?
[AGENT][NEUTRAL] Yes, um 359-7702.
[CUSTOMER][NEUTRAL] OK. So have you sent any letter to the employer or the um member to, for the eligibility?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, when is, uh, sent a letter.
[AGENT][NEUTRAL] The same day we process the last claim. Every time we process the claim, we send out the notice.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] But still no no uh responsibility from the patient or employee, right?
[AGENT][NEUTRAL] I'm sorry, can you repeat?
[CUSTOMER][NEGATIVE] Uh, I sending a letter also there is no like an update from the patient or employee.
[AGENT][NEGATIVE] No, there's no updates. We have um processed 3 times with this one, but there's no updates, correct.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Just a moment, uh.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, thank you. So we have to contact the member to for the uh for the eligibility, right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][POSITIVE] OK, thank you so much for the mail reference number.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK. Thank you so much for that. Have a great day.
[AGENT][POSITIVE] You're welcome, you as well, and thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah, bye bye.