AccountId: 011433970860
ContactId: 4fc6b1b0-174d-4dd6-a67f-bf33105b1044
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406350 ms
Total Talk Time (AGENT): 135532 ms
Total Talk Time (CUSTOMER): 114963 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/4fc6b1b0-174d-4dd6-a67f-bf33105b1044_20250523T12:40_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] Hi, [PII]. My name is [PII] calling from provider's office to check for a claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII]. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Two claims.
[AGENT][NEUTRAL] Alright, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. It's [PII] and extension will be [PII].
[AGENT][NEUTRAL] Thank you. And may I have the first member's policy number?
[CUSTOMER][NEUTRAL] Mm. Sure.
[CUSTOMER][NEUTRAL] It's 025182227.
[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] Yeah.
[CUSTOMER][NEUTRAL] Member's name will be, it's [PII]. Date of birth is [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 and the total bills for the claim?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Day of services on [PII]. Charge amount for $336 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][POSITIVE] Mm, that's right.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So this policy is active, but it didn't become active until [PII]. So I'm gonna look at the policy that was active before this, uh, because that would have been active on the data service.
[AGENT][NEUTRAL] And that's policy number 2369789.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see if it's on here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Well, still, I still don't see a claim for [PII] though. Um, however, this policy was active on the data service, so you can file the claim, um, there's no timely filing.
[CUSTOMER][NEUTRAL] Can I get to know what will be the time to filling limit?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEUTRAL] No time. OK.
[CUSTOMER][NEUTRAL] And you stated this um member was not active for data service or you member was active for data service?
[AGENT][NEUTRAL] No, I said the member was active on the data service and there's no timely filing, so you can still file the claim.
[CUSTOMER][NEUTRAL] OK. Can I get to know the eligibility for the member?
[AGENT][NEUTRAL] But you will have to
[AGENT][NEUTRAL] This policy was active from [PII].
[CUSTOMER][NEUTRAL] And uh can you please verify the mailing address? It's um [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It's [PII]. OK. [PII]. Is that right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And uh can I get to know the payer ID ones?
[AGENT][NEUTRAL] Sure, I pay ID is 60801.
[CUSTOMER][NEUTRAL] 60801. OK.
[CUSTOMER][NEUTRAL] Yeah. OK, fine. Thank you very much. And can I get uh the call reference for this claim?
[AGENT][NEUTRAL] Sure, so there's no call reference number for the entire call. You can use my name in today's date, which is [PII].
[CUSTOMER][NEUTRAL] Yeah. OK, fine. Thank you. And can I move with [PII]?
[AGENT][NEUTRAL] Um, hold on one moment, I'm noting this policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and the next member's policy number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. 01867061.
[AGENT][NEUTRAL] 01867061.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's for [PII]. Date of birth is for [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] The service is on [PII] and charge amount for uh
[CUSTOMER][NEUTRAL] $135 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, so there's no claim on file for [PII] for the member.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] [PII], no claim on file.
[CUSTOMER][NEUTRAL] Member's eligibility.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] The policy is still active. It's been effective since [PII].
[CUSTOMER][POSITIVE] Yeah, OK, fine. Thank you very much for your assist. Have a great day. Bye-bye. Take care, [PII].
[AGENT][NEUTRAL] You're welcome. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] That's all for today. Thank you.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day bye bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.