AccountId: 011433970860
ContactId: 410eef80-d412-48f9-854d-c9087b993bb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 680719 ms
Total Talk Time (AGENT): 154359 ms
Total Talk Time (CUSTOMER): 286008 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/410eef80-d412-48f9-854d-c9087b993bb8_20250220T14:45_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi. My name is [PII]. My last name is [PII]. I would like to hear some claim status for the, uh, today's call.
[AGENT][NEUTRAL] Do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] Sure. I do have it. It's [PII] and it's a direct line.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes. So the first policy number is 013559352.
[AGENT][NEUTRAL] Hold on one moment, [PII].
[CUSTOMER][NEUTRAL] OK, no issues. And in the meantime, may I have your name spell the last name for documentation purpose?
[AGENT][NEUTRAL] [PII], last [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] And what
[AGENT][NEUTRAL] What's your patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's that policy number again? I think I have too many numbers.
[CUSTOMER][NEUTRAL] OK, no issues. It is 013559352.
[AGENT][NEUTRAL] OK, that's too many numbers. Do you have the social?
[CUSTOMER][POSITIVE] Yes, I do have it.
[AGENT][NEUTRAL] OK, what is the social security number?
[CUSTOMER][NEUTRAL] The last four of your social security number is [PII].
[AGENT][NEUTRAL] I have to have the whole social security number. I can't look it up by the last.
[CUSTOMER][NEUTRAL] OK. So it is [PII].
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's the policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I think you gave me 251355 is what you have given me.
[CUSTOMER][NEUTRAL] Yes, that is the member ID which shows in my end. Maybe there was an error here.
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It was [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were needing claim status?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] The service was on [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And that was on [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] No claim on file. This policy canceled 7123.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No claim on file.
[CUSTOMER][NEUTRAL] And may I know if the patient was, if uh I mean active for the data service?
[AGENT][NEUTRAL] That's what I just told you. It canceled 7123, so no, it was not active at that time.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Not active.
[CUSTOMER][POSITIVE] Thank you so much for that information. And uh can you check if there any other coverages active for the same date of service?
[AGENT][NEGATIVE] I already checked. There's not.
[CUSTOMER][POSITIVE] OK, great. Thank you so much.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Great. Thank you so much for the information. So,
[CUSTOMER][POSITIVE] I'm ready with the next member ID whenever you are ready.
[AGENT][NEUTRAL] OK, I can help you with 3 and then you'll have to get someone else, OK?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK, no issues.
[AGENT][NEUTRAL] Hold on one moment, let me get this notes in.
[CUSTOMER][POSITIVE] OK, no issues you can take your time.
[CUSTOMER][NEUTRAL] of the
[AGENT][NEUTRAL] And what's the next policy number?
[CUSTOMER][NEUTRAL] It was 02145098.
[CUSTOMER][NEUTRAL] So by this family.
[AGENT][NEUTRAL] Patient's name?
[CUSTOMER][NEUTRAL] Patients name [PII] when he.
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No claim on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can you check this patient's effective and term data as well for me?
[AGENT][NEUTRAL] Effective [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Cancel [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So the patient was active for the data services, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And uh uh can you verify the mailing address for me?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Q
[CUSTOMER][NEUTRAL] So, uh, here, the mailing address was [PII]. So, uh, this claim was sent to incorrect address, right?
[CUSTOMER][NEUTRAL] Mhm. Great. Uh, so, uh, yeah, I would like to also check that, is that the same mailing address for the [PII] claims as well, the mailing address which you provided, OK.
[AGENT][NEUTRAL] I guess.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much for that. Mm, OK, great. Thank you so much. And uh uh can I have the timely filing to submit the claim?
[AGENT][NEGATIVE] We do not have timely filing.
[CUSTOMER][NEUTRAL] OK. Uh, so what you, I can resubmit the claim with the proof of timely filing, right, which the claim was sent to incorrectly?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] And may I know what uh mailing address the claim should be submitted along with the proof of timely filing? The same mailing address which you give, OK.
[AGENT][NEUTRAL] The same address.
[CUSTOMER][POSITIVE] Thank you so much for that.
[CUSTOMER][NEUTRAL] Is there any uh payer ID that we could send the claim to electronic mode?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] OK, thank you so much for that.
[CUSTOMER][NEUTRAL] And uh yeah, for this claim, I have got enough information from you and uh I'm ready the next patient here.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] It is 02061534.
[AGENT][NEUTRAL] Patient's name.
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] OK, we do not, um, hold on just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What was the date of birth again? You said [PII] CDO.
[CUSTOMER][NEUTRAL] Yeah, it was [PII].
[AGENT][NEUTRAL] OK, we do not administer these policies. You will have to call Web TPA for this policy. It's 866.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] 9759458. We do not do the claims for this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for the information. So, as you said, well 3 claims can be uh provided for this call. I think uh we have exhausted that so now I'm ready for the call reference number.
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for that as well. And yeah, thank you so much for your uh.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] For calling APL Sarah. You have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Mm