AccountId: 011433970860
ContactId: 4b3cfdca-35d6-4e42-bfbf-91115bcf3abc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 703700 ms
Total Talk Time (AGENT): 105333 ms
Total Talk Time (CUSTOMER): 368939 ms
Interruptions: 12
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/4b3cfdca-35d6-4e42-bfbf-91115bcf3abc_20250128T18:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you for calling.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Hi, this is [PII] from provider office.
[AGENT][POSITIVE] How can I help today, Lucky?
[CUSTOMER][NEUTRAL] Uh, I need a claim status regarding, need a claim status regarding a member.
[AGENT][NEUTRAL] OK, I'm happy to check on a claim. What's the policy?
[CUSTOMER][NEUTRAL] I to.
[CUSTOMER][NEUTRAL] Policy number is 088.
[CUSTOMER][NEUTRAL] 620977
[AGENT][POSITIVE] All right, lucky, thank you. Let me try and pull this up one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just to confirm, the policy number was 088620977.
[CUSTOMER][NEUTRAL] I just.
[CUSTOMER][NEUTRAL] 86.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's not coming up unfortunately. Do you have the member's name or social?
[CUSTOMER][NEGATIVE] I that's unfortunately.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, uh, let me, uh, check.
[CUSTOMER][NEUTRAL] Uh, I think I have the social.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] No, I don't have the social purpose as a member. Uh, can you open, uh, uh, it by another way?
[AGENT][NEUTRAL] I can look it up by their name. What's the first name?
[CUSTOMER][NEUTRAL] Uh, first name is [PII]. Uh, I can spell it. Uh, uh, the first name is like, uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh the last name?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, let me take a look by their name here give me just one moment.
[CUSTOMER][POSITIVE] Absolutely
[CUSTOMER][NEUTRAL] Mhm sure.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's the patient's date of birth?
[CUSTOMER][NEUTRAL] And let's
[CUSTOMER][NEUTRAL] Uh, patient date of birth is [PII].
[AGENT][NEUTRAL] OK. One moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Do you have a claim number or anything?
[CUSTOMER][NEUTRAL] Uh, claim number, uh.
[CUSTOMER][NEUTRAL] No, uh, this is showing, um, uh, no, there is only primary, uh, uh, remittance I have. The primary is Blue Cross Blue Shield of Alabama.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh it is showing here that Alliance, uh we send it electronically, yes.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yes, um, to alliance. Um, I can give you the payer ID.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEGATIVE] Um, yeah, that's not gonna help me find the number.
[CUSTOMER][NEUTRAL] Mm yeah.
[CUSTOMER][NEUTRAL] Uh, the payer ID?
[AGENT][NEUTRAL] I, yeah, I don't need the payer ID. Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can give you the place of the.
[CUSTOMER][NEUTRAL] Uh, home place name?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, it is showing here the patient is blonde.
[CUSTOMER][NEUTRAL] So, uh,
[CUSTOMER][NEUTRAL] The address is showing here is [PII].
[CUSTOMER][NEUTRAL] ZIP code is [PII].
[AGENT][NEUTRAL] Do you have the member's card or anything for this plan?
[CUSTOMER][NEUTRAL] Do you have the
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEGATIVE] Because I'm not able to find a member with that information.
[CUSTOMER][NEUTRAL] You find a member.
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] Let me check if, like, uh, just checking the document if I have.
[CUSTOMER][NEUTRAL] Anything
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, OK. This one is
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] Health insurance claim. Sorry, I'm taking your time.
[AGENT][POSITIVE] Oh, no worry.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I found the claim image. Uh.
[CUSTOMER][NEUTRAL] The insurance number is showing here 088. OK, this one is the same.
[CUSTOMER][NEUTRAL] 620977
[AGENT][NEUTRAL] Yeah, that may be that may be their primary policy number because that's not their policy with us.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] that.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Uh, yes, uh primary showing here is, uh,
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield.
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield of Alabama.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, do you have any idea if, um, by seeing the policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] To which uh insurances?
[CUSTOMER][NEUTRAL] Policy to
[CUSTOMER][NEUTRAL] Policies belong
[AGENT][NEUTRAL] No, we don't have that information on file if they have primary insurance and I'm not able to find a member's account with that information that you've given me, the only other way that I can search is by social security number.
[CUSTOMER][NEUTRAL] we have that information on that if they have insurance.
[CUSTOMER][NEUTRAL] With that
[CUSTOMER][NEUTRAL] Mhm the only way that I can search.
[CUSTOMER][NEUTRAL] Uh, OK. Let me check on the document as I got.
[CUSTOMER][NEUTRAL] Uh, the secure social security number.
[CUSTOMER][NEUTRAL] Uh, please bear with me.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] SSN number is blank here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Let's
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] on
[CUSTOMER][NEUTRAL] Mm, I got the card.
[CUSTOMER][NEUTRAL] But it is
[CUSTOMER][NEUTRAL] Belong to BCBS.
[CUSTOMER][NEUTRAL] OK [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] If it doesn't say APL, then it would not be us.
[CUSTOMER][NEUTRAL] If it doesn't.
[CUSTOMER][NEUTRAL] ATN
[CUSTOMER][NEUTRAL] Group number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That's the card.
[AGENT][NEUTRAL] Does the card say APL on it?
[CUSTOMER][NEUTRAL] Uh, what do you say? ATL, ATL.
[AGENT][NEUTRAL] Right, does it say APL?
[CUSTOMER][NEUTRAL] Right, because we
[CUSTOMER][NEUTRAL] APL, OK, yeah.
[CUSTOMER][NEUTRAL] Uh, there is uh 3 letters on the card. It is showing PAC.
[CUSTOMER][NEUTRAL] PAC
[AGENT][NEUTRAL] BAC.
[CUSTOMER][NEUTRAL] Health version uh yes, uh, in front of uh health.
[CUSTOMER][NEUTRAL] Health reason
[AGENT][NEUTRAL] So that sounds like their primary insurance and not us because our card would say APL.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] APL. Yes, PAC PPA this is.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK this is this is.
[CUSTOMER][NEUTRAL] modify that.
[CUSTOMER][NEUTRAL] I also on me.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, I got the SSN, but, uh,
[CUSTOMER][NEGATIVE] There is a 4 digits only in the last.
[CUSTOMER][NEGATIVE] I think it's not gonna help us.
[AGENT][NEUTRAL] Yeah, unfortunately not. So you would have to reach out to the insured for more information cause I'm not able to find anything.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][POSITIVE] Yes, I got it.
[AGENT][POSITIVE] Is there anything else I can help you with today, Lucky?
[CUSTOMER][POSITIVE] Uh, uh, no, thank you. Thank you. Thank you for your time.
[AGENT][POSITIVE] Thank you. You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Uh