AccountId: 011433970860
ContactId: 6723ad92-d270-42a0-9cc5-2688d8ce63a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 331250 ms
Total Talk Time (AGENT): 134985 ms
Total Talk Time (CUSTOMER): 98750 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/6723ad92-d270-42a0-9cc5-2688d8ce63a8_20250227T16:28_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], um, I got a, um, explanation of benefits on two patients back from you guys. It says the um policy was terminated and we had verified the benefits the day before and it said that the policy was active, so we're just trying to figure out what was going on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you've received an explanation of benefits from APL and you just have some questions regarding the termination.
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] Dates. Yes, ma'am. I can help you with that. And so who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you. And the member's policy number, though, you said you have 2 different patients. Is it two different policies?
[CUSTOMER][NEUTRAL] Uh, it's no, it's the same policy. Uh, number is 02441116.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, thank you. So one moment please.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your first patient's policy num um, excuse me, your first patient's name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And then what is the other?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And date of birth?
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[AGENT][POSITIVE] OK, thank you
[AGENT][NEUTRAL] And what is the date of service for [PII] and total bill amount?
[CUSTOMER][NEUTRAL] Uh, 210 of 25, uh, total amount was 224.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, we also had a separate claim for him the same day, um, for Ortho Records.
[CUSTOMER][NEUTRAL] Uh, and.
[AGENT][NEUTRAL] OK, so let me, let's, let me do the first one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, let me do the first. I can only do the one day service at a time, so give me, I mean, and build them out so one second.
[CUSTOMER][NEUTRAL] OK, OK, OK, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what is the first claim number that you have for him or the claim number?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] It's 356-702-7.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so yes, I do see that that is the remark. Give me one moment.
[AGENT][NEUTRAL] OK, this policy shows a term date of [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] And I don't see that we have received any calls here at APL.
[AGENT][NEUTRAL] Recently regarding this policy.
[CUSTOMER][NEUTRAL] OK all right well then I'll need to call the parents, OK.
[AGENT][NEUTRAL] Yes, ma'am, because I don't see where we've had anyone request any information regarding eligibility or benefits since the middle of [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK dokey, alright well I will figure something out then all right well thank you so much I appreciate it.
[AGENT][NEUTRAL] OK. Well, you, yes, ma'am, you're certainly welcome. And just for future reference, you may already have this information, [PII], but we do have a portal, so if you should ever need an explanation of benefits uh for a patient, you can go to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, I'll do. Thank you.
[AGENT][POSITIVE] OK. All right. Well then, you're certainly welcome and thank you again for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.