AccountId: 011433970860
ContactId: 6a04da9e-f31a-4edc-a24b-5824da9fdf53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 324049 ms
Total Talk Time (AGENT): 110707 ms
Total Talk Time (CUSTOMER): 145454 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/6a04da9e-f31a-4edc-a24b-5824da9fdf53_20250217T17:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, my name is [PII]. I'm calling from Multi-are Health System, calling to check on the status of a medical claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, well, I can verify claim status for you and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] It is D 468-021-09.
[AGENT][NEUTRAL] Uh, it's not one of our policy numbers. You have the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, I'll spell out their name. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] OK. And the date of birth?
[CUSTOMER][NEUTRAL] Uh, her date of birth [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. And do you happen to have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Uh-huh. Mhm.
[AGENT][POSITIVE] Thank you, give me one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is for medical.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh let's see.
[AGENT][NEUTRAL] Um, if you like, I can give you their policy number with our company.
[CUSTOMER][NEUTRAL] OK, is the, well, I have the policy certificate, is it the 025650007?
[AGENT][NEUTRAL] It is, yes, ma'am. That's our policy number with us. Um, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] OK, OK, have that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me get that um amount.
[CUSTOMER][NEUTRAL] We got out of that.
[CUSTOMER][NEUTRAL] Um, let's see, I think we have a couple of them on here.
[CUSTOMER][NEUTRAL] 12:13.
[CUSTOMER][NEUTRAL] Oh no, OK, the first one's [PII] for 480.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then [PII]:13.
[AGENT][NEUTRAL] I do not show we received that claim.
[CUSTOMER][NEUTRAL] OK, it looks like those are going to IMA Inc [PII] in [PII].
[AGENT][NEUTRAL] Yes, ma'am. That's the correct um mailing address, um, but if you like, I can give you, it's when that claim is sent to that address, it's supposed to go to IMA and to APL uh since we hadn't received it, I can give you a fax number if you like to fax the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and can I have you check a couple others just to see if you have these dates on file?
[AGENT][NEUTRAL] It's OK for the same patient.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the next date?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEGATIVE] Uh, no, ma'am. We have not received that one.
[CUSTOMER][NEUTRAL] How about [PII] for [PII].
[AGENT][NEUTRAL] Uh, no, ma'am.
[CUSTOMER][NEUTRAL] Or [PII].
[CUSTOMER][NEUTRAL] I don't know if you'll have that. Is their plan still in effect?
[AGENT][NEUTRAL] I'm sure the policy is active, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so it was effective on what date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And current
[CUSTOMER][NEUTRAL] OK, it looks like we have some other claims that I need to send out so I wonder, I think I'm just gonna um.
[CUSTOMER][NEUTRAL] Yeah, I'll just resubmit a lot of these um and can I get that.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] I do
[CUSTOMER][NEGATIVE] We sent this it looks like with the incorrect we sent it with an ID number not the policy number.
[AGENT][NEUTRAL] Uh, that would have been fine. We, if it, like I said, if it's sent to that address in [PII], then it chose to go to IMA and to APL and it's just, we just hadn't received it. If it didn't have the correct policy number on there, they were still searched by the name.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, so yeah, it just went with like I said that um medical ID number starting with the [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 650007 is the policy number. OK, I will get that updated and then I will get this sent out to you.
[AGENT][NEUTRAL] All right. And is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Very good.
[CUSTOMER][NEUTRAL] Uh, do you use reference numbers?
[AGENT][NEUTRAL] Uh, no, ma'am. We don't give reference numbers, but you may use my name in today's date.
[CUSTOMER][NEUTRAL] OK and your name again?
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][POSITIVE] OK, very good, [PII], thank you so much for your help. You have a good day.
[AGENT][POSITIVE] Alright, you too, thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] Bye bye.