AccountId: 011433970860
ContactId: 3a7f01f2-cf72-410d-985d-f440e9cccb65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 561840 ms
Total Talk Time (AGENT): 213462 ms
Total Talk Time (CUSTOMER): 148497 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/3a7f01f2-cf72-410d-985d-f440e9cccb65_20250428T14:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] calling from the provider's office to check on our claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today, [PII]?
[CUSTOMER][NEUTRAL] Uh, so for, I do have 22 patients, 2 different patients, and for one patient, I do have only 1. And for the other, I do have like 5 more.
[AGENT][NEUTRAL] So a total of 6.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and may I have the first member's policy number?
[CUSTOMER][NEUTRAL] Yes, it's D as in Delta 47680761.
[AGENT][NEUTRAL] OK, do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] No, we don't have that.
[AGENT][NEUTRAL] OK, um, do you have the member's full social or their first and last name?
[AGENT][NEUTRAL] This the number is for 90 degree benefits, so we're not able to use it in our system. So I'm just trying to see if there's another way I could pull the policy.
[CUSTOMER][NEUTRAL] Let me check it.
[CUSTOMER][NEUTRAL] OK. The SSN is [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] Mhm. Yes, you're right.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And what is the member's first and last name?
[CUSTOMER][NEUTRAL] The first name is [PII] The last name is [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] OK, hold on one second. So the first name is [PII] No, that's the last name. The first name is [PII]. Hold on one second.
[AGENT][NEUTRAL] OK, because nothing came up with the social, so let me try with the first and last name.
[AGENT][NEUTRAL] Do you, is [PII] the policyholder or is he a dependent or spouse on the policy?
[CUSTOMER][NEUTRAL] Or is he
[CUSTOMER][NEUTRAL] No, it's a policy holder.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK. I think it's uh.
[AGENT][POSITIVE] Good, I can still hear you.
[CUSTOMER][NEUTRAL] Uh, I do see that it, it's, uh, uh, the date of birth is [PII], so.
[CUSTOMER][NEUTRAL] OK, we don't have the member ID, so we need to contact to the 90 degree benefit for this number.
[AGENT][NEUTRAL] You may need to, um, or
[AGENT][NEUTRAL] Um, see who the member has for their insurance, but, um, with the social, nothing came up or their first and last name and that the number is for 90 Degree benefits.
[CUSTOMER][NEUTRAL] OK, let me call them. Uh, as I previously said that, I do have one more claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] That member ID is D as in Delta 42026392.
[AGENT][NEUTRAL] OK, we can try for this number also, but that the number is for 90 degree benefits. Do you have their social and their first and last name?
[CUSTOMER][NEUTRAL] The first name is [PII] The last name is [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, and this is for the medical policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Let me check the date of birth.
[AGENT][NEUTRAL] OK, no, this is a different member. So no, if
[AGENT][NEUTRAL] Wait a minute. What's [PII]'s date of birth? I'm sorry, I got mixed up with the first one.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so this member does have a policy. What's the data service for the claims?
[CUSTOMER][NEUTRAL] Date of service is, yes, it's [PII].
[AGENT][NEUTRAL] Is this the member with
[CUSTOMER][NEUTRAL] The bill amount is 242.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Go ahead with the bill amount.
[CUSTOMER][NEUTRAL] Yes, it's $242 even.
[AGENT][NEUTRAL] OK, and is this the member with the 1 or the 5?
[CUSTOMER][NEUTRAL] I'm, I'm sorry, what is that?
[AGENT][NEUTRAL] Of the two members, you said one had 1 claim, one had 5. Is this the member with one claim or 5?
[CUSTOMER][NEUTRAL] Uh, one, only one thing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I was just gonna ask for them all at once. OK. Um, hold on one moment, let me look for that for you. And all the information provided is a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So I'm not showing that we've processed any claims for [PII]. Also, this policy um is no longer active as of [PII]. Um, it became effective on [PII].
[AGENT][NEUTRAL] She did have a policy after this one.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] OK, uh, I just missed it. Uh, but effective on [PII], what is the term date?
[AGENT][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the member was not active after the term date, right?
[AGENT][NEUTRAL] Well, there was another policy, um, policy number 230.
[AGENT][NEUTRAL] 2984.
[AGENT][NEUTRAL] This policy was active from [PII], but she didn't have any policies active on your date of service.
[AGENT][NEUTRAL] With APL.
[CUSTOMER][NEUTRAL] OK, there is no uh active plan for the data service. [PII], right?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] And there is no claim on file, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you very much, [PII], for assisting me on the call. Can I get the call reference and can I get the 90 degree benefits call number?
[AGENT][NEUTRAL] OK, so there's no call reference number. You can use my name and today's date, the first initial of my last name is [PII], and then on the back of their card, there should be an 800833 number. Um, I don't know the remaining numbers because it's a different company, but if do you have a copy of their ID card?
[CUSTOMER][NEUTRAL] No, we don't. Uh, so, OK, let me get it, uh, from a different way.
[AGENT][NEUTRAL] OK, let me see if I can find one for you.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Mhm. I have the reminding is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I can't confirm it for you because it's a different company and we, we don't have that number listed. That's the number on the back of their card.
[CUSTOMER][NEUTRAL] Mhm. OK, I got it. And your call reference is your name and today's date, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you very much for assisting. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] You're very welcome, sir. Thanks for calling APL. Is there anything else I can assist with?
[CUSTOMER][NEUTRAL] No, that's the last of 3.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye bye.