AccountId: 011433970860
ContactId: 541255cc-08d3-41b2-a7b9-45432818da97
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 622539 ms
Total Talk Time (AGENT): 223612 ms
Total Talk Time (CUSTOMER): 170651 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/541255cc-08d3-41b2-a7b9-45432818da97_20250626T15:48_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]. I'm calling from the provider's office, but I'm not sure I got the right department trying to check status on a claim.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] I have D as in Delta 49100065.
[AGENT][NEUTRAL] And do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] On the ID card, do you see anywhere that says um inpatient or outpatient policy cert number?
[AGENT][NEUTRAL] It should start with a 01 or 02.
[CUSTOMER][NEUTRAL] I don't see anything say 3 number.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] I just had it says it's a it says temp staff.
[CUSTOMER][NEUTRAL] And it has employee ID the number I just gave you and then.
[CUSTOMER][NEUTRAL] The patient's name.
[CUSTOMER][NEUTRAL] And then it has multiplan, but then on the back of the card, the copy shows.
[CUSTOMER][NEUTRAL] Male claim to benefit in
[AGENT][POSITIVE] Benefits in the car. OK.
[CUSTOMER][NEUTRAL] BIC
[AGENT][NEUTRAL] Um, what's the members, uh, well, do you have the the member's full social on file?
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Since it's waiting for the policies to pop up here, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have the member's first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, this is it.
[AGENT][NEUTRAL] All right, and I have him here. I just need you to verify the date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Um, so the policy number for APL is 261.
[AGENT][NEUTRAL] 41
[AGENT][NEUTRAL] 34
[AGENT][NEUTRAL] And may I have the date of service and the total bill for the claim you'd like the status on?
[CUSTOMER][NEUTRAL] Uh, date of service we have March, no, I'm sorry, it's [PII].
[CUSTOMER][NEUTRAL] And the bill is $2,919 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me see what this is. So we, I'm not showing anything from [PII], from [PII] something popped up, but let me see if this is the same bill amount. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the name of your provider's office?
[CUSTOMER][NEUTRAL] State of Mississippi, University of Mississippi Medical Center.
[AGENT][NEUTRAL] What's the um procedure code on your claim?
[AGENT][NEUTRAL] Or are there multiple?
[CUSTOMER][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Multiple.
[AGENT][NEUTRAL] OK. So we don't have a claim on file for you, but there's no um timely filing, so you could still file the claim if you'd like. Um, let me double check the, yeah, the policy is still active.
[CUSTOMER][NEUTRAL] OK, so the number you gave me that um 261-4134 uh do I need to change that from what we have on this uh letter D 491?
[AGENT][NEUTRAL] Yes, because that the number that
[CUSTOMER][NEUTRAL] Uh, that number or
[AGENT][NEUTRAL] That the number is 90 Degree benefits um policy number. So yes, ma'am, you can change it to the 261, that's, that's for APL only.
[CUSTOMER][NEUTRAL] OK, so he has APL.
[CUSTOMER][NEGATIVE] And not 90 degree benefits.
[AGENT][NEUTRAL] Well, it's both, but we can't use their policy number.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] I'm, I'm, I guess I'm confused, so APL and.
[AGENT][NEUTRAL] So it's a hospital indemnity.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] So it's a hospital indemnity policy, so their insurance is through benefits in a car. So it sounds like they also have like maybe some wellness benefits that 90 degree benefits may provide, which is where that D number comes in, that's their policy number. But for anything with APL and like what we just went over, it would be the 261-4134 because we can't use the other company's number.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and let's see.
[CUSTOMER][NEUTRAL] Do you have a fax number we can fax the bill to or is there just a mailing address?
[AGENT][NEUTRAL] Um, just the mailing address. There's no fax number, but there is a payer ID.
[AGENT][NEUTRAL] If you'd like to
[CUSTOMER][NEUTRAL] Well, we have it set up so paper. It's not set up for the electronics.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the uh mailing address?
[AGENT][NEUTRAL] OK, so it's [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] N.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK. That's what we got.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I was looking at what we have. I said that's what we have on file. [PII]. The claim was mailed [PII], so it hadn't been, well, it'll be a month tomorrow. It was mailed out on [PII] to the address, but it has that D number on it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, we do, let me, let me see if there's a way I can see what this is because we did receive some documents.
[CUSTOMER][NEUTRAL] For the member ID.
[AGENT][NEUTRAL] [PII] and [PII], but you said you sent it in in May.
[CUSTOMER][NEUTRAL] It was mailed out on [PII].
[AGENT][NEUTRAL] I mean
[AGENT][NEUTRAL] I can look and see if you like, um, because there are some claims that there are some um documents that are processing right now. You want me to just make sure, you know, see if it's yours? OK.
[CUSTOMER][NEUTRAL] OK, if you can check that won't have to go to mail it out again and you already have it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right, OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, it was [PII].
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I go through the documents?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] She said [PII]. This is, no, that's not it.
[AGENT][NEUTRAL] Just say it.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] All right, thanks so much for holding. I apologize for that wait. So they are from UMMC but they are different dates of service, so we still haven't received the one for your date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Alright, thank you so much. I'll get this um sent out again and change this ID number.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Well, was there anything else I can help you with today? Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Alright, and do you have a reference number?
[CUSTOMER][NEUTRAL] Do you have a reference number for our call?
[AGENT][NEUTRAL] No, ma'am, there's no call reference number, but you can use my name and today's date. And the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] All right, and what was your
[CUSTOMER][NEUTRAL] OK. And what was your name again? I'm sorry.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Alright, thank you so much, [PII].
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you bye