AccountId: 011433970860
ContactId: 3bdd77e6-0969-458d-b1fb-582276822797
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 388079 ms
Total Talk Time (AGENT): 153960 ms
Total Talk Time (CUSTOMER): 122538 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/3bdd77e6-0969-458d-b1fb-582276822797_20250214T19:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling Ail's [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi um I was calling to see if this patient has a medical plan with you guys?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, to see if this is this a, a medical plan insurance?
[AGENT][NEUTRAL] But, uh, um, I would just have to pull up the policy to see what type of policy they have. Um, can I get your name, please?
[CUSTOMER][NEUTRAL] OK. Um, can I give you the ID number? Oh yes, my name is [PII]
[AGENT][NEUTRAL] And then you can I get a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, the policy number?
[CUSTOMER][NEUTRAL] 02518092.
[AGENT][NEUTRAL] Excuse me, the member's name and date of birth?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yes, it's
[CUSTOMER][NEUTRAL] Sorry, I don't know how to pronounce the name here give me one second.
[CUSTOMER][NEUTRAL] It's, I'm sorry, I'm gonna spell it because I don't know how to pronounce it. It's [PII]
[CUSTOMER][NEUTRAL] And last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, let me give it that you said you wanna see um what type of policy this is.
[CUSTOMER][NEUTRAL] Uh, yeah, if they have a medical policy because the patient came to us for medical.
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] Um, [PII] and [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the member had a limited benefit policy. Um, what type of visit, um, was it?
[CUSTOMER][NEUTRAL] Um, it's just a medical, um, office visit.
[AGENT][NEUTRAL] OK, so give me 1 2nd.
[AGENT][NEUTRAL] So is it, was it a sick visit or preventative or um cause that's gonna determine.
[CUSTOMER][NEUTRAL] Um, OK, so the first one was a sick visit and then the second one was a preventative.
[AGENT][NEUTRAL] OK. So I'm showing the member's policy was active [PII]. It termed [PII]. Um, so we see if, um, of course the [PII] the, I think you said the [PII] wouldn't be covered, um, but let me see if it would cover anything for the other one.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, and you said the term one day sorry? [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Yes. So like it's a limited policy. So for sick doctor's visit, um, the policy, um, will pay up to $100 per day with a max of 4 allowed per calendar year. Um, so let me see.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Did you guys receive a claim from us by chance?
[AGENT][NEUTRAL] Uh, I'm looking at that next. And what was the first date in August?
[CUSTOMER][NEUTRAL] Yes, um, it was, sorry, let me just go back to that August, I'm sorry, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Looks like we received both. So [PII] was denied because the policy wasn't active as far as the other one, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What was the bill amount for the [PII]?
[CUSTOMER][NEUTRAL] Oh let me open that back up. It is 369-06.
[AGENT][NEUTRAL] OK, this is probably let me see.
[AGENT][NEUTRAL] I think probably not.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what was the name of the provider?
[CUSTOMER][NEUTRAL] Yes, it's um Seattle roots at Carolyn Downs.
[AGENT][NEUTRAL] Will it belabor Seattle?
[CUSTOMER][NEUTRAL] No, that's, um, not on us.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me see.
[AGENT][NEUTRAL] OK, so we didn't receive one from, as far as the doctor, we only see the one for the lab that they had done that day.
[CUSTOMER][NEUTRAL] OK, um, can I just verify the address with you to make sure that we have that correct?
[CUSTOMER][NEUTRAL] Sorry, let me get to that screen, um.
[CUSTOMER][NEUTRAL] The address that the patient provided was [PII].
[AGENT][NEUTRAL] OK, so that's our old address. I can give you our updated address or I can provide you with the fax number.
[CUSTOMER][NEUTRAL] OK, I'll take the new address that's fine.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Sorry, um, can I have the zip code again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, just make sure.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and I just got to make sure I got this correct this [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] Or was it
[CUSTOMER][NEUTRAL] Mm. Oh, OK, sorry, I, I, I heard that part, but then I missed the missed a part of it, sorry.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great thank you we'll get that filled out thank you.
[AGENT][POSITIVE] What kind of [PII]. Was there anything else that I can help you with today?
[CUSTOMER][POSITIVE] That's it. Thank you. Have a good day.
[AGENT][POSITIVE] You as well and thanks for calling APL.
[CUSTOMER][NEUTRAL] Oh.