AccountId: 011433970860
ContactId: 3462d8d5-b5ce-4961-9cbc-9c916da8c6d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372579 ms
Total Talk Time (AGENT): 123497 ms
Total Talk Time (CUSTOMER): 137879 ms
Interruptions: 3
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/3462d8d5-b5ce-4961-9cbc-9c916da8c6d2_20250605T20:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm looking for the client status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, just making sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Policy number is 02580380.
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And can you also just give me the website information.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII] with the date of birth, [PII].
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Day of services on [PII].
[AGENT][NEUTRAL] You said [PII] or [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not showing a claim for that date of service.
[CUSTOMER][NEUTRAL] OK, got it. And can I know the member's effective and term date of the policy?
[AGENT][NEUTRAL] OK. The policy's effective date is [PII].
[AGENT][NEUTRAL] The policy lapsed on [PII].
[AGENT][NEUTRAL] So the policy was active during the date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And it was done on [PII]. Am I right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, gotcha. And um after that, is there any active coverage for the patient?
[AGENT][NEUTRAL] You see.
[AGENT][NEUTRAL] Uh, no, ma'am.
[CUSTOMER][NEUTRAL] Can I know the patient's plan name and plan type?
[AGENT][NEUTRAL] This is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] Hospital internity policy. Uh, is there any plan types such as HM or PPO plan?
[AGENT][NEUTRAL] Um, no, we don't pay off of network or we're not in network with anyone, we just pay, uh, benefit amounts.
[CUSTOMER][NEUTRAL] OK, got it. And can I know is there any group number for this plan or not?
[AGENT][NEUTRAL] Um, give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Group number is 70036.
[CUSTOMER][NEUTRAL] Uh, it's 2 consecutive zeros followed by 36. Am I right?
[AGENT][NEUTRAL] Yes, 70036.
[CUSTOMER][NEUTRAL] Can I know the group name?
[AGENT][NEUTRAL] Crown Services Inc.
[CUSTOMER][NEUTRAL] Ground services, OK. And can I know uh whether um APL is acting as primary or secondary insurance?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] I don't know if they have a primary insurance or not, um, but we're not major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got it. And can I know the mailing address for submitting the claim?
[AGENT][NEUTRAL] Mailing address? Sure.
[AGENT][NEUTRAL] It's claims department at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Can I get the payer ID for submitting the claim?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK, can I know the timely fi limit for submitting the claims?
[AGENT][NEGATIVE] Uh, we don't have timely filing.
[CUSTOMER][NEUTRAL] OK, got it. And uh I have one more data service for this patient. Could you check if there any claim on file or not?
[AGENT][NEUTRAL] For the same patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] A date of service is on [PII].
[AGENT][NEUTRAL] [PII]. OK, give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm not showing any claim for that data service either.
[CUSTOMER][NEUTRAL] OK, got it. Thank you for that info. And can I know the call reference number for our call today?
[AGENT][NEUTRAL] So we don't have call reference numbers you can use my name and last initial and today's date so [PII] and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I got enough for that info. That's all for today. Thank you for your assistance. Have a great day ahead.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Mhm. Bye-bye. Take care.
[AGENT][NEUTRAL] Bye.