AccountId: 011433970860
ContactId: 5b5cfbe1-62e1-4980-9762-5b0d925f779a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357339 ms
Total Talk Time (AGENT): 102410 ms
Total Talk Time (CUSTOMER): 136630 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/5b5cfbe1-62e1-4980-9762-5b0d925f779a_20250210T18:49_UTC.wav
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[CUSTOMER][NEUTRAL] That
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check the claim status.
[AGENT][POSITIVE] OK, [PII] and I'll be more than happy to help you with the claim status. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Uh, I have only one claim right now.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh yes, that will be [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, member's policy number is
[CUSTOMER][NEUTRAL] 02511179 M as in Mike, L as in Larry, 7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][POSITIVE] Oh yes, of course.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] The the member's name is [PII].
[CUSTOMER][NEUTRAL] And the 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 you want me to check on?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, that will be 0908-2024.
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] Uh, total bill amount is $43,891.42.
[AGENT][NEUTRAL] Alright, so I'm actually showing that there's no claim on file for [PII] for um [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, but we recently, uh, contacted you and still there is no claim on file. Just give me a second.
[CUSTOMER][NEUTRAL] OK. Can you confirm me the, uh, just give me a second.
[CUSTOMER][NEUTRAL] 10:14.
[CUSTOMER][NEUTRAL] Can you confirm me the mailing address?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Yes, um, our mailing address is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. Can I also get the payer ID?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] 60801, right? OK. Can I get the effective date of member policy?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] The policy has been effective since [PII].
[CUSTOMER][NEUTRAL] [PII]. And the term date is?
[AGENT][NEUTRAL] The policy is still active?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Member was active on the date of service, right?
[AGENT][NEUTRAL] Yes, yes, your data service is September became active in August.
[CUSTOMER][POSITIVE] OK. Thank you for that information. OK.
[CUSTOMER][NEUTRAL] Uh, can you confirm the mailing address again, uh, just to uh cross-check?
[AGENT][NEUTRAL] Our claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, no problem. Can I get the timelyifying limit?
[AGENT][NEUTRAL] There's no timely filing limit, um, as long as the policy was active on the data service.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, no timelyifying as a member was active for the date of service, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Just give me a second. I'll check if I have any other claims also.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, can I get the call reference number?
[AGENT][NEUTRAL] So there's no call reference number. You can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Can I also get your name, please?
[AGENT][NEUTRAL] Yes, I just gave you my name. It's [PII].
[CUSTOMER][POSITIVE] OK. And uh thank you for that information. Have a great day.
[AGENT][POSITIVE] You're very welcome, [PII] and thanks for calling APL. I hope you have a great day as well. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And