AccountId: 011433970860
ContactId: 6a432201-927d-4dfa-8f2d-1eeb9a8aa398
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365899 ms
Total Talk Time (AGENT): 178715 ms
Total Talk Time (CUSTOMER): 114745 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/6a432201-927d-4dfa-8f2d-1eeb9a8aa398_20250108T18:43_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, you said your name is [PII]?
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Hi, my name's [PII]. I'm calling from West Kendall Baptist Hospital. I was trying to see if a claim had been received. Um, would you be able to assist?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, I'd love to help you with claim status today, my friend, and do you mind if I get a good call back number from you?
[CUSTOMER][NEUTRAL] Sure, it's excuse me, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you I appreciate that and your member's policy number?
[CUSTOMER][NEUTRAL] Yes, um, 01533856 ML 8.
[AGENT][POSITIVE] Perfect and give me a moment to get that pulled on up.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Would you be able to please verify your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, uh first name [PII], last name [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Perfect. I do see her here and then you're just wanting to check that a claim has been received, correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] All right, let me pull that up.
[AGENT][NEUTRAL] I'm not showing that we've received any claims for your insured. Um, hold on one second though, let me check something out.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] and tight actually.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So it actually looks like your insured has an updated policy number. Um, would you mind if I went ahead and gave that to you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Sure, no problem.
[AGENT][NEUTRAL] Alright, I have the new policy number listed as 024862993.
[CUSTOMER][NEUTRAL] 02486293. Alright, um, is that, is that oh go ahead.
[AGENT][NEUTRAL] Mhm. And I.
[AGENT][NEUTRAL] Oh no, I was supposed to say I have your claim too, but um what was your question? I'm so sorry.
[CUSTOMER][NEUTRAL] Oh, you have the claim? Is it, uh, well.
[CUSTOMER][NEUTRAL] I was gonna ask about the idea if it was effective for the data service um for the claim I'm uh asking is for uh [PII].
[AGENT][POSITIVE] Yes, it was effective during that time period, um.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Perfect, yes. So I have that we received your claim on [PII], and the claim was processed on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, and it is for that data service 8-10-2024 for West Kendall Baptist Hospital.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And I have your claim number is 353-8545.
[CUSTOMER][NEUTRAL] 353-854-5
[AGENT][NEUTRAL] You know, and I actually it looks like they processed it as a duplicate so let me take a look because it looks like maybe there's another one on file somewhere.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, we, it was sent over twice excuse me, because we didn't receive any um payment information.
[AGENT][NEUTRAL] OK, so, um, let me see, let me go back to the original claim, um, I was able to find that one it looks like we received it on [PII] we processed it on [PII] and the claim number for that one is going to be 3502164.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah that's
[AGENT][NEUTRAL] And that one did have benefits payable. It looks like we had $300 paid by check and the check number was 2000773 and if you give me one moment I'm gonna load up those check details.
[CUSTOMER][NEUTRAL] Is that 300 123?
[AGENT][NEUTRAL] Yes, it was 300.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] I do show that the check was cut on [PII] and then the check was cleared on [PII]. It looks like it went to [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] That's correct, 7.
[CUSTOMER][NEUTRAL] [PII] yep, that is the right address. OK, alright, was that a bulk check?
[AGENT][NEUTRAL] No, it was a single check.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] OK, so the, the other one I'm checking on with the process as a duplicate.
[AGENT][NEUTRAL] Yes, yeah, the one that had just come in in December processed as a duplicate for that original one.
[CUSTOMER][POSITIVE] Perfect. All right, that is everything I needed. It's been awesome. Um, is there a call reference number for today?
[AGENT][NEUTRAL] Yeah, you bet you. It's gonna be my name [PII], first initial last name, [PII], and today's date?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Alright, that is all I needed. Thank you again. You have a great rest of your day.
[AGENT][POSITIVE] Hey, it's my pleasure thank you for calling APL and you have a great day as well take care.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][NEUTRAL] Bye bye.