AccountId: 011433970860
ContactId: 6a4fdb0e-02b6-4c1c-b9e5-545327935765
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 329869 ms
Total Talk Time (AGENT): 132664 ms
Total Talk Time (CUSTOMER): 111340 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/6a4fdb0e-02b6-4c1c-b9e5-545327935765_20250618T14:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, very good morning, [PII]. My name is [PII], and my name is [PII] for Cad. I'm calling from Prora's office to check the claims.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] 11 single client.
[AGENT][NEUTRAL] Alright, may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] It's.
[CUSTOMER][NEUTRAL] Contact number is [PII] with the [PII] [PII]. Policy ID I have 022980788.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Do you mind to spell out your name?
[AGENT][NEUTRAL] My name is [PII] The [PII] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And [PII], can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII]. The patient name is [PII].
[CUSTOMER][NEUTRAL] DOB I have [PII].
[AGENT][NEUTRAL] Alright, you said your name is [PII], not [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth again? I'm sorry.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] charge amount is $250 even.
[AGENT][NEUTRAL] OK, so this policy, this is the latest policy they've had. Um this was active from [PII]. So we don't have a policy that was active on the data service. I can look and see if there's a claim here for you though.
[CUSTOMER][NEUTRAL] But the claim received to you on February month has been having some posted claim number.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office that would be on the claim?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] So we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 360.
[AGENT][NEUTRAL] 7947.
[AGENT][NEUTRAL] And also on [PII], we denied the claim.
[AGENT][NEUTRAL] Because the services were rendered after coverage was terminated?
[CUSTOMER][NEUTRAL] So [PII] it was been terminated. I know the effect to date one more time.
[AGENT][NEUTRAL] The policy was effective from [PII].
[AGENT][NEUTRAL] To [PII].
[CUSTOMER][NEUTRAL] After that, do you have any coverage for this, uh, the active coverage with the next policy, or do you remember have any other insurances on file? Our member is listed with any other DL policies within your ABL.
[AGENT][NEUTRAL] No, there's no other policies with APL. If the insured has other insurance, um, you would have to go through them.
[CUSTOMER][NEUTRAL] Only member you don't provide?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Need to contact patient?
[AGENT][NEUTRAL] Correct. The policy with APL is no longer active. They don't have any other policies with us, so you would have to contact the insured to see who their insurance is with.
[CUSTOMER][NEUTRAL] And thank you so much for the details. Uh, can you please send me the UOB copy for this one to my fax and confirm the claim number I took right or wrong that is 36.
[AGENT][NEUTRAL] We
[AGENT][POSITIVE] Sure, it was a good
[CUSTOMER][NEUTRAL] Fax number I have [PII].
[CUSTOMER][NEUTRAL] Yeah, OK, fax number 561.
[CUSTOMER][NEUTRAL] 303 2.
[CUSTOMER][NEUTRAL] [PII] is the ending four digits of the fax, OK? You may keep my name in the attention box for your reference fax number again 56,110.
[AGENT][NEUTRAL] OK, OK, OK, hold on, hold on, hold on. I'm sorry. I, I need to be able to follow correctly. So the fax number is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] You got it.
[AGENT][NEUTRAL] And is that attention, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, so I'm sending the explanation of benefits over to you now. And was there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, this claim number is 3607947.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Call reference and then thank you.
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] Hope you have a good one bye.