AccountId: 011433970860
ContactId: 427873b3-ffdd-4360-b847-03d665c6b2cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 322869 ms
Total Talk Time (AGENT): 144979 ms
Total Talk Time (CUSTOMER): 83654 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/427873b3-ffdd-4360-b847-03d665c6b2cc_20241231T14:02_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I was calling for claim status please.
[AGENT][NEUTRAL] OK, you're needing to check claim status.
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][POSITIVE] Yes, I can help you with that and who am I speaking with?
[CUSTOMER][NEUTRAL] Do
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And how many claims [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] Just one for right now.
[AGENT][NEUTRAL] Uh, OK. And what is that member's policy number, please?
[CUSTOMER][NEUTRAL] I have 024168692.
[AGENT][POSITIVE] Thank you. One moment, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so we have a number, we have an extra number somewhere. Can you repeat that number again?
[CUSTOMER][NEUTRAL] I have 024168692 might be the 0.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, it's still an extra number. Do you have a copy of the ID card?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Let me check. I'll have to double check.
[CUSTOMER][NEUTRAL] I gotta pull up a program so I can pull up the card.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] If it's there
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Fingers crossed.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What is the name?
[AGENT][NEUTRAL] Patient's name?
[CUSTOMER][NEUTRAL] The patient's name? [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh yeah, no. I was just trying to see if maybe I could.
[AGENT][NEGATIVE] Tweak that number to see where the error might be, but that didn't work.
[CUSTOMER][NEUTRAL] Uh, all I have is her Blue Cross Blue Shield, her primary insurance.
[CUSTOMER][NEUTRAL] I don't have her secondary.
[AGENT][NEUTRAL] Do you have her full social?
[CUSTOMER][NEUTRAL] Her social is [PII].
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] OK, let me see if I can locate her information that way.
[AGENT][NEUTRAL] And uh, any information that I do provide today will be a verification of benefits and not a guarantee of payment. What is her date of birth?
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] OK, thank you. So the correct policy number should be 02.
[AGENT][NEUTRAL] 16.
[AGENT][NEUTRAL] 8692. There is no 4 in her policy number.
[CUSTOMER][NEUTRAL] Oh, so, OK, is there a group number?
[AGENT][NEUTRAL] The group number is 13854.
[CUSTOMER][NEUTRAL] OK, I guess we'll have to resubmit because we submitted it with the wrong ID.
[AGENT][NEUTRAL] Oh my goodness, OK, um, what is the, what is the data service and total bill amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] [PII] $667.40.
[AGENT][NEUTRAL] OK, just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'll just check.
[AGENT][NEUTRAL] Yeah, we do not have a claim on file for her for that day sir, 5:30, 2024.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have a payer code?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60. OK, give me that one again, please.
[AGENT][NEUTRAL] Uh-huh. 60801.
[CUSTOMER][NEUTRAL] OK. Thank you. And a reference number, please?
[AGENT][NEUTRAL] And yes, would be my name and today's date, [PII], and then also once the claim has been processed, we do have a portal. It is called the online service center and you can set up a username and password by going to secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Am public.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you can also have access to the EOB there as well, once it's processed.
[CUSTOMER][POSITIVE] OK. OK. I'll fill that out. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you are welcome. And can I help you with anything else today?
[CUSTOMER][POSITIVE] No, ma'am. Thank you.
[AGENT][POSITIVE] Well, you're welcome and thank you for calling APL. I hope you have a great day and a safe and happy New Year. Thank you. Thanks. Bye-bye.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Bye.