AccountId: 011433970860
ContactId: 40ce46b2-93da-400f-98b4-8aea5827df2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 366019 ms
Total Talk Time (AGENT): 67395 ms
Total Talk Time (CUSTOMER): 123882 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/40ce46b2-93da-400f-98b4-8aea5827df2f_20250502T19:14_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, definitely. My name is [PII] calling on behalf of provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] No, uh, oh, sorry. The callback number would be [PII].
[AGENT][NEUTRAL] OK, you have the policy number of the patient?
[CUSTOMER][NEUTRAL] So, the policy number would be 60801.
[AGENT][NEUTRAL] Um, that's our payer ID.
[AGENT][NEUTRAL] You have the policy number?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, no, then this the number I have. Just give me one second.
[CUSTOMER][NEUTRAL] Let's try to pull it up from the.
[CUSTOMER][NEUTRAL] OK. Uh, the subscriber ID.
[CUSTOMER][NEUTRAL] No, this is for different insurance, uh.
[CUSTOMER][NEUTRAL] No. Can I help you with the social security number?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just give me 1 2nd.
[CUSTOMER][NEUTRAL] Just check whether I have that.
[CUSTOMER][NEUTRAL] No, actually, I don't have this information.
[AGENT][NEUTRAL] Yeah, the last name of the patient?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Sure, the patient's name, last name would be [PII]. I mean, sorry, [PII].
[AGENT][NEUTRAL] First name is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you have a group number or?
[CUSTOMER][NEUTRAL] Uh, I do have one group number. Uh, it was like 26159.
[AGENT][NEUTRAL] OK. Do you have her date of birth?
[CUSTOMER][NEUTRAL] Member's date of birth would be [PII].
[AGENT][NEUTRAL] OK, and you have the date of service and bill charges?
[CUSTOMER][NEUTRAL] D of service falls on [PII].
[AGENT][NEUTRAL] Um, looks like that's before the effective date. Let me see if there's a different policy. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh no, this is the only policy I have. Um, hold on just a second.
[AGENT][NEUTRAL] Oh, actually, it was effective [PII]. I don't have that claim on file.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh, do you have the member ID of that?
[AGENT][NEUTRAL] Yes, it's 244-891-4.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that's the member ID OK.
[CUSTOMER][NEUTRAL] So it is 244-8914, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh there's no claim on file. Uh what was the payer ID you mentioned?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801. OK. And your payer name would be APL, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And uh your mailing address?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] And uh what would be your family time limit?
[AGENT][NEGATIVE] And there's no timely filing limit.
[CUSTOMER][NEUTRAL] And uh what, the group number is the same that I told, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, and uh
[CUSTOMER][NEUTRAL] The member's effective date was from [PII], right?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Select
[AGENT][NEUTRAL] Still active, yes.
[CUSTOMER][NEUTRAL] OK. And what plan type is it? Is it PPO, HMO or EPO?
[AGENT][NEUTRAL] It's a supplemental policy, so it's none of those, just a secondary supplemental.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Uh, thanks so much for your time. I really appreciate it. So we'll just try to submit the claim since there is no claim on file. And uh may I have your call reference number?
[AGENT][NEUTRAL] Um, it's my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK. OK, [PII]. So thanks so much for your time. Have a great and happy weekend ahead. Stay safe. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL you as well. Bye bye.