AccountId: 011433970860
ContactId: 6cecbb7d-b260-4de1-b936-7d64558ffcec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401079 ms
Total Talk Time (AGENT): 93586 ms
Total Talk Time (CUSTOMER): 235631 ms
Interruptions: 5
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/6cecbb7d-b260-4de1-b936-7d64558ffcec_20250424T19:23_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] calling from provider office. Can you please help me with the claim status?
[AGENT][NEUTRAL] Yes, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Um, just, uh, a moment, please. Uh, uh, uh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] So the callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have uh the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh, as I have, uh, I will provide you.
[CUSTOMER][NEUTRAL] The policy number is um
[CUSTOMER][NEUTRAL] 002513755
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient's uh last name is [PII] and the first name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEGATIVE] You will go there. You will come here, but you will not come in this place. No, I will not.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, that, that name is not in our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, can I have any alternative to find a claim status?
[AGENT][NEUTRAL] You have a claim number?
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] No, but the claim was forwarded from the uh United Healthcare.
[AGENT][NEUTRAL] Yeah, I, I, you have a group number?
[CUSTOMER][NEUTRAL] Which number? Group number uh let me check it uh.
[AGENT][NEUTRAL] Group
[CUSTOMER][NEUTRAL] No, insured group number not mentioned in my system. But we have, uh, OK, but I do have the address.
[AGENT][NEUTRAL] OK, yeah, I cannot locate it based on the.
[CUSTOMER][NEUTRAL] Yeah, let's say
[AGENT][NEUTRAL] Address of what?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Address of insurance.
[CUSTOMER][NEUTRAL] American Public Life.
[AGENT][NEUTRAL] Right, I, I believe you've called on this patient several times, but we're, they're not in our system, so I'm not sure you'll need to contact the patient or the provider.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] not in our system.
[CUSTOMER][NEUTRAL] OK. So not in the system means you didn't receive the claim or uh you are not able to uh pull the patient with these details which are uh shared.
[AGENT][NEUTRAL] I can't pull the patient's details with the information you've provided.
[CUSTOMER][NEUTRAL] OK. Rather than uh insured ID, can you try with the patient's name, date of birth, and date of service?
[AGENT][NEUTRAL] Yes, I tried with the name, and that's the only way I can look. I can look by group name, group ID.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Member ID and name. I can't search by date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh. So without the insured ID, can you try it again?
[AGENT][NEUTRAL] So you will need to call.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what is it?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What was the number?
[CUSTOMER][NEUTRAL] Uh, which number?
[AGENT][NEUTRAL] I don't, you said you wanted me to try a number again? Which number are you wanting me to try?
[CUSTOMER][NEUTRAL] Without insured ID, can you please try with only patient name, date of birth, and date of service so that we might, uh, pull the patient.
[AGENT][NEUTRAL] I can't
[AGENT][NEUTRAL] I can only search by name, which I've tried. There's no [PII] in our system. I've tried with the number you provided me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I, you don't have a group number, so that would be another option. I cannot search by date of birth or date of service.
[CUSTOMER][NEUTRAL] OK. Is there any portal, uh, to check, uh, claim status for AMP APL sorry, APL?
[AGENT][NEUTRAL] Yes, but for this patient you're referencing, you're not gonna find anything because they're not in our system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, you can go to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, then. Yeah, thank you for your assistance. Uh, can I have your uh call reference number?
[AGENT][NEUTRAL] Reference number is my name and today's date.
[CUSTOMER][NEUTRAL] 99 and today's date.
[AGENT][NEUTRAL] Uh, my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Yes, OK. Uh thank you, [PII], for your assistance. Have a good day. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye. Bye