AccountId: 011433970860
ContactId: 65796cdf-cb65-452e-964c-67cff016f97f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296359 ms
Total Talk Time (AGENT): 64334 ms
Total Talk Time (CUSTOMER): 172830 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/65796cdf-cb65-452e-964c-67cff016f97f_20250417T20:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] in customer service. How are you?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] I am good thank you um I have [PII] on the line he is calling to check claim status.
[AGENT][POSITIVE] OK, I can help him.
[CUSTOMER][NEUTRAL] All right. Um, the policy he's calling about is 166.
[CUSTOMER][NEUTRAL] 0258.
[CUSTOMER][NEUTRAL] Um, he's calling about participant 2.
[CUSTOMER][NEUTRAL] Um, but he said her date of birth is [PII] and we have [PII]. Um, I was actually trying to see if we have like a original application to check that up again.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then he got talking to me about something else and I forgot. Um, I'm pulling it up now. Um.
[CUSTOMER][NEUTRAL] His callback number?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, will you give me that policy number one more time? I'm sorry.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, that's OK. 166-0258.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and that was on [PII]?
[CUSTOMER][NEUTRAL] Yes, but he, he did give me a date of birth that's not matching what we have.
[CUSTOMER][NEUTRAL] Um, so, but I do not see a, um, original application either in Onase so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know what we would need to do. um, I guess we'd have to reach out to the group to verify that if they, if the claim and it could already have a hub request to verify that. I'm not sure.
[CUSTOMER][NEUTRAL] Um, but he's calling to check claim status on her, and he also said that he was having difficulty with the online service center.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm not sure if y'all do that for providers. I know that claims used to help them, but I'm not sure if y'all know how to do that yet.
[AGENT][POSITIVE] Yeah, yeah, we can help.
[CUSTOMER][NEUTRAL] OK, perfect. Alright, well, um, I gave you his name and his phone number and the policy number, so alright, well, here he comes, [PII], thank you.
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] This is [PII]. Can I help you?
[CUSTOMER][NEUTRAL] Hey, hi. Uh, my name is [PII] and I'm calling from provider's office to check on a claim status for a member.
[AGENT][NEUTRAL] OK, and then you have the patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was that date of service?
[CUSTOMER][NEUTRAL] Yeah, for this number, the date of service is January, sorry, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, don't show anything on file for that date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK, no problem. Let me submit the claim, to submit the claim the claim mailing address and the timely filing limit.
[AGENT][NEUTRAL] Uh, there's no timely filing limit. Claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. OK. Is there any fax number to submit the claim?
[AGENT][NEUTRAL] Yes, fax number is [PII].
[CUSTOMER][NEUTRAL] OK, so while submitting the fax, we need to submit just the claim form, right?
[AGENT][NEUTRAL] Uh the claim and then the primary explanation of benefits.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] And can I get the payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] OK, got it. Thank you. That's it from my end. Can I get the call reference number?
[AGENT][NEUTRAL] A call reference number is my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Yeah, thank you, [PII]. Have a great day.
[AGENT][POSITIVE] Thank you, you too. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] You too bye.