AccountId: 011433970860
ContactId: 4200492c-8849-4e72-bdfa-f8cc8b3c7beb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279299 ms
Total Talk Time (AGENT): 102623 ms
Total Talk Time (CUSTOMER): 98891 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/4200492c-8849-4e72-bdfa-f8cc8b3c7beb_20250625T17:00_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, [PII] and my name is [PII]. I'm calling from the office for claims and how are you doing today?
[AGENT][NEUTRAL] I'm fine. I can verify claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, sure. So the policy number uh that is going to be 14977 0 sorry, sorry. I just provided to the NPI. Sorry for that. It's going to be 02114666 M for Mike, L for Lima, 8.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, I do. So the callback number [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] OK OK. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Yeah, sure. So the patient name is uh [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Mm yeah, sure. So the date of service is [PII] and the total amount billed is $3150 even.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And do you have the balance after Primary is processed the claim?
[CUSTOMER][NEUTRAL] Mm, no. This is the primary American public life for this member.
[AGENT][NEUTRAL] No, this is a secondary policy they have with our company, and it shows the claim had been received and processed as the inpatient benefit has maxed for the year.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, who, who is the primary then for this particular member?
[AGENT][NEUTRAL] Uh, you have to contact the patient since this is a secondary supplemental policy.
[CUSTOMER][NEUTRAL] OK. You don't have any primary details, who is the primary like that?
[AGENT][NEUTRAL] You have to contact the patient because this is a secondary policy only.
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] No, I'm asking you, you don't have any information about who is primary like that?
[AGENT][NEUTRAL] And I'm saying that you need to contact the patient. They would have their primary insurance information. This policy is secondary only.
[CUSTOMER][NEUTRAL] Uh, but they have stated that this is the primary for the.
[AGENT][NEUTRAL] Well, they are incorrect. They might need to contact their group to verify who their primary insurance is with because this is a secondary policy only.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. Uh, and what is the reference number for this call?
[AGENT][NEUTRAL] You may use my name in today's date and it's spelled [PII].
[CUSTOMER][POSITIVE] Thank you so much. Uh, what is the claim number for that?
[AGENT][NEUTRAL] Sure. Claim number is 3583075.
[CUSTOMER][NEUTRAL] OK. And I just want to know when I know the claim receive date and process date.
[AGENT][NEUTRAL] Uh, claim was received on.
[AGENT][NEUTRAL] [PII], process on [PII].
[CUSTOMER][NEUTRAL] It's [PII] uh.
[CUSTOMER][NEUTRAL] So I, another claim, I have one more claim for this member it's going with the same date of service and the bill amount is $3060.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, I show that claim also processes the inpatient benefits of max claim received on.
[AGENT][NEUTRAL] The same date, [PII], processed on [PII].
[CUSTOMER][NEUTRAL] What is your claim number?
[AGENT][NEUTRAL] 3583077
[CUSTOMER][POSITIVE] OK. Thank you so much. Hopefully, have a great day.
[AGENT][POSITIVE] You too, thanks for calling APL bye.