AccountId: 011433970860
ContactId: 5218af2c-48ff-417d-899e-feda8bed0e38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292920 ms
Total Talk Time (AGENT): 103385 ms
Total Talk Time (CUSTOMER): 120705 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/5218af2c-48ff-417d-899e-feda8bed0e38_20250613T20:50_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Gastroenterology of Ker Orlando. And I'm checking on claim status. Could you please spell out your name for me?
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII]. And may I have a callback number just in case we get disconnected, Ms. [PII]? You're welcome.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Yeah, sure, it's [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. Prescription policy number is 02424884 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh sure. Patient name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, the date of service is for [PII] and the total bill amount is $82.97.
[AGENT][NEUTRAL] OK, thank you. Let me see if I can find this claim for you. And for future, you can check claim status online through our website at [PII], and that's just optional. Um let's see. Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't have a claim on file for this member.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I don't have that claim on file.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Is the claim on file?
[AGENT][NEUTRAL] No, the claim is not on file.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] Uh, we do submitted this claim, uh, under the mailing address, uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII] is [PII].
[CUSTOMER][NEUTRAL] Is that right?
[AGENT][NEUTRAL] Yes, that is her address [PII], [PII], [PII]. The zip code is [PII].
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Uh, and we do have faxed this claim, uh, uh, on, uh.
[AGENT][NEUTRAL] You can fax them, you need to fax him.
[CUSTOMER][NEUTRAL] Yeah, with the fax on [PII]. Under the fax number [PII].
[AGENT][NEGATIVE] That is the correct fax number, but it did not get here. We don't have no claims on file for that date of service.
[CUSTOMER][NEUTRAL] The fact
[CUSTOMER][NEUTRAL] So, again, we have to submit as a through fax or we have to submit as a paper claim?
[AGENT][NEUTRAL] You can fax it or mail it.
[CUSTOMER][NEUTRAL] You can
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh thank you and.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] May I have the member's effective date?
[AGENT][NEUTRAL] Oh, sure.
[CUSTOMER][NEUTRAL] sure
[AGENT][NEUTRAL] OK. The effective date on the policy is [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] And is there any time limit for submitting the claim?
[AGENT][NEUTRAL] No, we don't have family family limits.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, thank you so much for that information. And can I get the call reference number for this number?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK, thank you so much and thank you so much for your assistance. Have a great day.
[AGENT][POSITIVE] You as well. Thank you for calling ATL. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you.