AccountId: 011433970860
ContactId: 68c4910d-89dc-4e16-a9ad-cb0087b3c5f6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257428 ms
Total Talk Time (AGENT): 75030 ms
Total Talk Time (CUSTOMER): 114221 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/68c4910d-89dc-4e16-a9ad-cb0087b3c5f6_20250204T15:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I'm calling for the provider trainees at Medical Center. Inc. Please know this call is being recorded and monitored for quality and training purpose, and I'm calling to check on a claim status.
[AGENT][NEUTRAL] OK, I can help you spell your name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] And that's D as in Delta 42030118.
[AGENT][NEUTRAL] Do you have a copy of the identification card? Our number's gonna begin with a 0.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, uh, uh, could you try with the member's name and date of birth?
[AGENT][NEUTRAL] Spell the first and last name, please?
[CUSTOMER][NEUTRAL] So the member's first name is spelled as [PII]. And the last name is [PII].
[AGENT][NEUTRAL] In what state does the patient reside?
[CUSTOMER][NEUTRAL] Um, just a moment, let me check.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And is this a medical claim?
[CUSTOMER][NEUTRAL] So that's [PII].
[CUSTOMER][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] And if you can provide the patient's date of birth.
[CUSTOMER][NEUTRAL] Sure. The date of birth is [PII].
[AGENT][POSITIVE] Thank, thank you.
[AGENT][NEUTRAL] And what is the uh you said we're checking claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that data service?
[CUSTOMER][NEUTRAL] [PII] and the charge amount is $331.24.
[AGENT][NEUTRAL] OK, I do not show any claims on file for this patient.
[CUSTOMER][NEUTRAL] Um, actually, we submitted this claim to the address [PII].
[CUSTOMER][NEUTRAL] So that's the incorrect one?
[AGENT][NEGATIVE] It's not correct. The correct mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, you can uh [PII].
[AGENT][NEUTRAL] And what's the name of the company that you emailed it to the address that that you gave me, who is that for?
[CUSTOMER][NEUTRAL] And the.
[CUSTOMER][NEUTRAL] Um, so it's CWI benefits management benefits.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the payer ID?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh may I have the time finding limit?
[AGENT][NEGATIVE] To submit a claim, there's no timely?
[CUSTOMER][NEUTRAL] Yes, and may I have the patient plan effective date and the termination date?
[AGENT][NEUTRAL] Policy is no longer active as of [PII]. Effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you so much. And this is a primary insurance for the member?
[AGENT][NEUTRAL] I can't verify if they have other coverage or not. That's a question for the patient.
[CUSTOMER][NEUTRAL] OK, so you can't able to verify that information.
[AGENT][NEUTRAL] I don't have the information, so now you'll have to check with the patient.
[CUSTOMER][NEUTRAL] All right. And um may I know the preferred mode to submit the claim either is it through electronic or by mail?
[AGENT][NEUTRAL] It's your preference?
[CUSTOMER][NEUTRAL] Thank you. And may I have the reference number?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII]. Any other questions I could help out with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Um, no, that's it for today. Thank you so much for your assistance, [PII]. Have a nice day.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you. Thank you, bye.