AccountId: 011433970860
ContactId: 30dbc011-5fe5-4470-a2e5-6d27890456ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272380 ms
Total Talk Time (AGENT): 96860 ms
Total Talk Time (CUSTOMER): 110901 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/30dbc011-5fe5-4470-a2e5-6d27890456ce_20250401T14:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from the provider's office to check the claim status.
[AGENT][NEUTRAL] OK, yeah, I can check on a claim for you. uh [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line. OK?
[AGENT][NEUTRAL] OK, thank you, and then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh yes, uh, the policy number is 02492946.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then uh what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yes, sir. It's [PII] and uh [PII] is date of birth, OK.
[AGENT][NEUTRAL] Perfect, thank you for verifying that and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes, uh, start date is [PII]. End date is [PII]. And the charge amount?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 5379.00. OK.
[AGENT][NEUTRAL] So $5,379 even, correct?
[CUSTOMER][NEUTRAL] Uh, it's $5,379 even, yes.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And [PII], I'm sorry, what was the name of the provider's office this was with?
[CUSTOMER][NEUTRAL] Yes, uh, it's OK. It's uh Trident Medical Center.
[AGENT][NEUTRAL] OK, thank you for that. Give me just a moment. OK, so we did receive this claim, uh, looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, just give me a second. I just need to check. OK. Uh, so may I know when the patient recently upgraded the coordination benefit?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Could you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] May I know when the patient recently updated the coordination of benefit?
[AGENT][NEUTRAL] Um, I'm not sure as this policy is no longer active.
[CUSTOMER][NEUTRAL] 00, OK. I mean the patient policy is also terminated. Is it correct?
[AGENT][NEUTRAL] Yes, the termination, it was active during this state of service, um, the term date was [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so then, thank you for the data service. Also, you, you are not aware for that information, right? Uh, when the patient recently updated the benefit, right? You're not aware of information, right?
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Uh, may I know, OK. May I know through which the patient can update the benefit by any phone number to reach and update the codation benefit, member service line number?
[AGENT][NEUTRAL] Um, I'm honestly not sure. I don't know who they have as their primary, as this is their secondary medical policy.
[CUSTOMER][NEUTRAL] So you are not aware of uh who's primary, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Uh, can I get that, uh, phone number or the patient can update uh the potential benefit, any phone number available?
[AGENT][NEUTRAL] Um, they could simply call us at this line. They could simply call us at this line.
[CUSTOMER][NEUTRAL] To reach the member service line.
[CUSTOMER][NEUTRAL] Uh, the same number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's the same number, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Is there any specific time limit to update these details?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK. May I know the claim number?
[AGENT][NEUTRAL] Yes, that is 348-023-8.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the received date?
[AGENT][NEUTRAL] That was [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][NEUTRAL] Process it.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Could you please spell out your name, just make a note.
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Can I get the reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date, uh, so my last initial is [PII] Was there anything else I could help you with with?
[CUSTOMER][POSITIVE] Oh, OK. Thank you so much, and no, nothing else. Thank you so much, bye.