AccountId: 011433970860
ContactId: 4085b65e-db5b-40bf-bc87-5b2bb6ce3e03
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 448440 ms
Total Talk Time (AGENT): 114161 ms
Total Talk Time (CUSTOMER): 129954 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/4085b65e-db5b-40bf-bc87-5b2bb6ce3e03_20250411T18:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and the last nation name is [PII].
[AGENT][POSITIVE] Thank you for that. And how may I assist you today, [PII]?
[CUSTOMER][NEUTRAL] Actually, I'm looking for my claim status.
[AGENT][POSITIVE] OK, well I'll be more than happy to help you with the claim status and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Actually, I have one claim.
[AGENT][NEUTRAL] OK, and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The member policy number is 22797007.
[AGENT][POSITIVE] Thank you for that. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. Hold on one moment. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. The member first name.
[CUSTOMER][NEUTRAL] Is the [PII], last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The date of service is [PII]. And the date of, sorry, the total bill amount is $1820.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] The facility name is the sorry, office name. The office name is the [PII].
[AGENT][NEUTRAL] OK, so we only have one claim on file. It's a different provider and a different total bill. So we don't have a claim on file for yours. Do you have a claim number?
[CUSTOMER][NEUTRAL] Actually I have no claim number.
[AGENT][NEUTRAL] OK. Um, I just want to make sure, but just looking at the
[CUSTOMER][NEUTRAL] One second, let me check. Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The one second, let me check the claim number.
[CUSTOMER][NEUTRAL] Yeah, that is the no claim number.
[AGENT][NEUTRAL] OK, um, so there's no claim on file, however, um, you can file the claim, um, as long as it was active on the data service. um, so you do have time to file the claim.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK. What is the claim TFL?
[AGENT][NEUTRAL] There's no timely filing as long as the policy is active, you can file the claim at any time.
[CUSTOMER][NEUTRAL] OK. And what is the uh
[CUSTOMER][NEUTRAL] Sorry, what is the uh claim mailing address? We can do EFT uh uh paper claim otherwise the any mailing address?
[AGENT][NEUTRAL] Our mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] One second, let me check.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh the address is [PII], OK. [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh let me check.
[CUSTOMER][NEUTRAL] OK. You will verify that you claims sent to the paper claim otherwise the any
[CUSTOMER][NEUTRAL] You receive the paper claims otherwise, any claims.
[AGENT][NEUTRAL] There's not
[AGENT][NEUTRAL] We have not received the claim, but you can, you can submit it for processing.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Electronic, yeah, otherwise the paper claim which you have received.
[AGENT][NEUTRAL] So if you're going to file it uh through a paper claim, it would be the mailing address that I gave. If you want to file electronically, our payer ID is 60801.
[CUSTOMER][NEUTRAL] And then let me check.
[CUSTOMER][NEUTRAL] What is the ID?
[CUSTOMER][NEUTRAL] Paper ID Per ID?
[AGENT][NEUTRAL] A, a payer ID.
[AGENT][NEUTRAL] Our payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure. Can you give me the call the phone number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, OK, [PII]. Sure.
[CUSTOMER][POSITIVE] Thank you so much. Have a nice day.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, no. Thank you so much.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.