AccountId: 011433970860
ContactId: 5ae20877-2b21-42be-aae8-bf5a36bf6ecc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 375279 ms
Total Talk Time (AGENT): 153976 ms
Total Talk Time (CUSTOMER): 82787 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/5ae20877-2b21-42be-aae8-bf5a36bf6ecc_20250411T20:25_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, hi [PII], this is calling from provider's office to checking on a claim status. Could you please assist me today?
[AGENT][NEUTRAL] Yes, I can assist you with the claim status and I couldn't hear your name. Can you repeat that, please?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, my contact number is gonna be [PII].
[AGENT][NEUTRAL] I'm sorry, can you repeat that slowly, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, the member's policy number is gonna be 02185085 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII] and 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 for the claim and the total bills?
[CUSTOMER][NEUTRAL] Yeah, can I get your name please before this?
[AGENT][NEUTRAL] Yes, again, my name is [PII] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And the date of service is [PII] and total charge is $42,629 even.
[AGENT][NEUTRAL] OK, can you repeat that amount slowly, please? 42,000?
[CUSTOMER][NEUTRAL] $629 even.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] For [PII], I'm not showing a claim on file for [PII].
[AGENT][NEUTRAL] Actually, hold on one moment. There's an active policy. Hold on one moment.
[AGENT][NEUTRAL] So the active policy and the policy active on your data service with policy number 2337102. So I'm gonna look at that policy and see if there's a claim on there. Hold on one moment.
[AGENT][NEUTRAL] OK, but even on the active policy, there is no claim on file for [PII], um, but the policy was active on the data service, so you can file the claim if you need to.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] There's no claim on file, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] How is in this time.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] How to submit this claim through paper or via mail, uh, through mail or else electronic?
[AGENT][NEUTRAL] Um, that's up to you. You can mail it, you can.
[AGENT][NEUTRAL] You can mail it, you can fax it, or you can send it electronically. Which one would you prefer?
[CUSTOMER][NEUTRAL] OK, can I get the fax number?
[AGENT][NEUTRAL] Yes, our fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] [PII] 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a 2nd may I patient confirmed it.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] May I know the patient effective on term date?
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] For the policy number that you gave me ending in 5085, the policy was active from [PII]. The active policy number.
[AGENT][NEUTRAL] It's 233-71.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] 02
[CUSTOMER][NEUTRAL] No, I was asking the to.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, the uh it is uh
[CUSTOMER][NEUTRAL] 5120 222.
[AGENT][NEUTRAL] Are you asking for the policy number that you gave or the current policy that this would be under?
[AGENT][NEUTRAL] There are 2 different policies. I was giving you both.
[CUSTOMER][NEUTRAL] Your current
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So which one would you like?
[CUSTOMER][NEUTRAL] Go ahead, uh.
[CUSTOMER][NEUTRAL] Uh, I need to check with the policy, your currently, current policy number.
[AGENT][NEUTRAL] Right, so the policy number that you provided ended in 5085. That's the
[AGENT][NEUTRAL] Effective date and termination date that I just gave. The policy number I was trying to give you is 2337102, which is the active policy, and it's been effective since [PII] and it's still active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. And again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, [PII], thank you. Thanks for listening today. Have a good day. Bye-bye.
[AGENT][POSITIVE] Thank you, [PII]. You also, thanks for calling APL.