AccountId: 011433970860
ContactId: 649fbf8a-735e-4fc2-85bd-e650e3d781ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236119 ms
Total Talk Time (AGENT): 72859 ms
Total Talk Time (CUSTOMER): 130421 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/649fbf8a-735e-4fc2-85bd-e650e3d781ff_20250428T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. I'm calling because um I have uh a statement that I received from one of my providers, um, and I just asked them if they submitted a claim to you guys because I thought they didn't have my insurance, my insurance on file, but they did. So they basically told me that they submitted a claim in February and that they got, um, just a response saying that they were, they were not gonna pay or something, so I just want to find out to see what happened.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with the status of that claim. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure. My name is [PII] and my phone number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get your policy number, please?
[CUSTOMER][NEUTRAL] OK, give me one second. I have, would that be, um, I have here on the card, I have a group number and then I have an outpatient because it was actually an outpatient. I have an outpatient benefit certificate number. Is that the one that you need?
[AGENT][NEUTRAL] Yes, ma'am. That's your policy number.
[CUSTOMER][NEUTRAL] OK, sure. So it's 02.
[CUSTOMER][NEUTRAL] 09
[CUSTOMER][NEUTRAL] 983 6 ML 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] Yes, it is [PII], and my address is [PII].
[AGENT][NEUTRAL] OK, and please verify your email address.
[CUSTOMER][NEUTRAL] Um, I'm not sure if you guys have my work email, um, or my personal email. My personal email is [PII].
[CUSTOMER][NEUTRAL] Um, and my email address at work are [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yes, ma'am. We have your email address on file, um, your work email address on file.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh, my work, OK, perfect. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And please verify your home address one more time.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the date of service for the claim you're calling about?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It's a 0, no, sorry, [PII]. So it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file. They said that they filed the claim with us?
[CUSTOMER][NEUTRAL] Right, they said that they filed a claim in February.
[AGENT][NEUTRAL] Mm OK. No, ma'am. I'm not showing a claim on file with that date of service, but there's no timely filing limit, so they can always get it filed as long as you had coverage on that date of service and I'm showing that your coverage was active, so they can file the claim.
[CUSTOMER][NEUTRAL] OK, so should I just tell them to call you guys back?
[AGENT][NEUTRAL] Yes, ma'am. They can give us a call back, be sure to um give them your policy number so they can verify your benefits and we can explain to them how to file a claim if they're not familiar with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help I appreciate it. I'm gonna go ahead and call them right now.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That will be all. Thank you. I appreciate your help. Have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL bye.
[CUSTOMER][POSITIVE] Thank you.