AccountId: 011433970860
ContactId: 48d3feef-b047-4d96-8c3e-df5dba94516e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 432190 ms
Total Talk Time (AGENT): 144764 ms
Total Talk Time (CUSTOMER): 193786 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/48d3feef-b047-4d96-8c3e-df5dba94516e_20250212T16:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] and I'm calling from provider's office to get a claim information. And how are you doing today?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] Yeah, I'm too good. Thank you so much for asking too.
[AGENT][NEUTRAL] That's good, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have only one client.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm. Sure, the contact number is, one moment.
[CUSTOMER][NEUTRAL] It is [PII]
[CUSTOMER][NEUTRAL] [PII]. And it's a direct line, you can use my name for a reference.
[AGENT][NEUTRAL] Thank you for that. And you said your name is [PII]?
[CUSTOMER][POSITIVE] Yes, [PII]. You're right.
[AGENT][NEUTRAL] OK, and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Mhm. The member's policy number is, one moment.
[CUSTOMER][NEUTRAL] Yeah, it is 02543916.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] The member's name is
[CUSTOMER][NEUTRAL] [PII], and the date of birth is on [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 for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] It is $554 even.
[AGENT][NEUTRAL] And you said [PII], um, [PII]?
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK. So I'm not showing a claim on file for [PII] for [PII]. Let me see if there was another policy active.
[CUSTOMER][NEUTRAL] OK. And also in the claim form, I have a
[AGENT][NEUTRAL] No, this is the only one.
[CUSTOMER][NEUTRAL] OK, got it. Uh, sorry to interrupt you. Uh, in the claim form, I have uh one more member ID I think so. Uh, can you check with that, please?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For the same member.
[AGENT][NEUTRAL] For this claim?
[CUSTOMER][NEUTRAL] Yeah. Uh, there is another member ID for the same member. Uh, can you check with that, please?
[AGENT][NEUTRAL] Well, she has two other um member IDs, but they were not active on your data service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy number that you gave me was the only policy that was active.
[AGENT][NEUTRAL] On your data service.
[CUSTOMER][NEUTRAL] OK. Can you
[CUSTOMER][NEUTRAL] OK, got it. I, I just noted that. Uh, just to verify, uh, can I verify with you this, uh, member ID?
[CUSTOMER][NEUTRAL] For the same number. OK. Uh, it is uh 01959890.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, that was her first policy. It was active from [PII]. And then she had another policy after that, but that policy, um, 2129441, was active from [PII].
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Give me one moment, let me document that so for this.
[CUSTOMER][NEUTRAL] Team member ID.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] From
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, [PII], was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah, uh, almost done. So the current member ID which is 0254316 is still active, right? That member ID is uh active, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can you please tell me the date and termination for that member ID please? I apologize.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] The policy is still active and I'm sorry, the policy was effective from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. That means uh
[CUSTOMER][NEUTRAL] OK, got it. So active for the data service. No claim on file, right? Claim on file.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And uh uh can I verify you the mailing address where we submitted this one and the
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. This claim has been submitted to the [PII]. Is that the right address?
[AGENT][NEGATIVE] No, that doesn't, um, that's not the correct address for this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Can I get the correct address, please?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] And can I get the payer ID please?
[AGENT][NEUTRAL] 60.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what is the family filing limit to submit that?
[AGENT][NEUTRAL] There's no timely filing limit. Um, you can file at any time as long as the policy was active on the data service.
[CUSTOMER][NEUTRAL] OK, uh, uh, but, uh, no time limit, but the patient is, uh, inactive now. We can submit, right? Because the term term date is [PII].
[AGENT][NEUTRAL] Right, but the policy was active on the day of service, so you can still file the claim even though the policy is no longer active.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you, thank you so much. And uh can you please uh spell your name for me, please?
[AGENT][NEUTRAL] Sure, my name is [PII] The [PII].
[CUSTOMER][NEUTRAL] OK, and can I get a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first [PII] to my [PII] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. Thank you for assisting me in this. Have a great day and take care. Bye for now. Thank you.
[AGENT][POSITIVE] Thank you, I'll see you also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah, bye-bye.