AccountId: 011433970860
ContactId: 6d945803-1276-41a7-bb62-2a6cf705fbd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394019 ms
Total Talk Time (AGENT): 134909 ms
Total Talk Time (CUSTOMER): 164394 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/6d945803-1276-41a7-bb62-2a6cf705fbd2_20250528T18:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Oh, hi, [PII]. This is [PII], and I'm calling from Fairview Park Hospital. I'm checking on a bill or a claim for the patient. Can you help me with that?
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the claim status, and [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] this one
[AGENT][NEUTRAL] All right. And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII] is the contact number.
[CUSTOMER][NEUTRAL] And the policy number I have is 860751999.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] 86
[CUSTOMER][NEUTRAL] And your name, please?
[AGENT][NEUTRAL] Hold on, my name is [PII]. The policy number you said 860751999?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Um, that's not an APL policy number. Do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me check.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Mm, no, it doesn't show any card copy.
[CUSTOMER][NEUTRAL] They do not any card a copy of the patient.
[AGENT][NEUTRAL] OK, I can search the policy with the full social.
[CUSTOMER][NEUTRAL] Uh, can I give you the social number?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The social number for the patient I have is
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So I'm waiting for the policies to populate. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the member's first and last name?
[CUSTOMER][NEUTRAL] If there's any, any worker.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And this is for the medical policy?
[CUSTOMER][POSITIVE] Mhm. That's correct.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Alright, and can you verify the member's date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And the policy number is 1052099.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 201052099. OK.
[AGENT][NEUTRAL] That's, that's one of them. And what is the data service for the claim and the total bills?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, it's [PII]. Bill amount is $2,02.75.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Alright, now it's [PII] $2,225.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 2,0002.75 cents
[CUSTOMER][NEUTRAL] $2,0002.75.
[AGENT][NEUTRAL] $2,202.75.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Are you able to hear me just
[AGENT][NEUTRAL] Listen, can you just give the number?
[CUSTOMER][NEUTRAL] 2002.75.
[AGENT][NEUTRAL] OK, $2,0002.75. Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the most recent policy that the member has is 1666.
[AGENT][NEUTRAL] 624. That policy was active from [PII]. I can look to see if there's a claim on file there for you, but there were no active policies on the data service.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, means in the date of service.
[CUSTOMER][NEGATIVE] There's no active coverage, or no active.
[CUSTOMER][NEUTRAL] And for the policy number which you gave me 1052099?
[AGENT][NEUTRAL] That was the first policy that they had. Their most recent policy is policy number 1666624.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What you
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it was active from [PII], I'm sorry to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And after that, there was no policy, correct? No other insurance or policy, patient has it.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And no other insurance you find do you find any other insurance for the patient?
[AGENT][NEUTRAL] There's no other
[CUSTOMER][NEUTRAL] After your policies too.
[AGENT][NEUTRAL] They don't have any other policies with APL.
[CUSTOMER][NEUTRAL] OK. So I think I should send a letter to the patient regarding this then.
[CUSTOMER][NEUTRAL] Thanks. Any reference number for the call?
[AGENT][POSITIVE] You're welcome [PII].
[AGENT][NEUTRAL] There's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] OK. Thanks.
[CUSTOMER][POSITIVE] Oh, no, that's it. Thank you. Thank you so much and have a nice day.
[AGENT][POSITIVE] You're welcome thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] You too. Bye.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Um