AccountId: 011433970860
ContactId: 737cabf6-fdb9-495c-8e41-af35ea9fbbf5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 463320 ms
Total Talk Time (AGENT): 146425 ms
Total Talk Time (CUSTOMER): 142772 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/737cabf6-fdb9-495c-8e41-af35ea9fbbf5_20250411T18:19_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] Hi, [PII]. My name is [PII], and the last initial name is [PII].
[AGENT][NEUTRAL] OK, how are you doing today, [PII]?
[CUSTOMER][POSITIVE] I'm good and you?
[AGENT][POSITIVE] I'm doing well. How may I assist you today?
[CUSTOMER][NEUTRAL] Actually, I'm looking for my claim status. Your name is [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And the last initial?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK. Can you give me the claim status?
[AGENT][NEUTRAL] Yes, may I first have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, the, the contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] The member policy number is 4389, sorry, sorry, I repeat again. 02341055.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] The member first name is, one second. The member's first name is
[CUSTOMER][NEUTRAL] [PII], last name is uh [PII] and the date of birth is
[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 may I have the date of service for the claim you'd like me to check on and the total bills?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] Yeah, the total charges, is
[CUSTOMER][NEUTRAL] 3,708.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, wait a minute.
[AGENT][NEUTRAL] 37083352325.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So this claim is actually processed under another um policy number and that policy number is 220.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] 1794.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That policy was active from [PII].
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK. What is the status?
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] The claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 3352325.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Can you check the primary you has been sent on, uh, one second, let me check.
[CUSTOMER][NEUTRAL] Primary, you will be sent to the uh [PII]. You have received the
[CUSTOMER][NEUTRAL] You be or not?
[AGENT][NEGATIVE] We have not received the EOB.
[CUSTOMER][NEUTRAL] OK, you not receive the UOB. Actually, you have received through the fax. You have received the UOB or not?
[AGENT][NEUTRAL] The EOB has not been received, but you can submit it for uh continue processing.
[AGENT][NEUTRAL] You can fax it, you can mail it, or you can send.
[CUSTOMER][NEGATIVE] OK. You will be not received.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. What is the mail?
[CUSTOMER][NEUTRAL] What is the fax number?
[AGENT][NEUTRAL] 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 877
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 365
[CUSTOMER][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK. And the mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 9
[CUSTOMER][NEUTRAL] 1 2nd, 1 2nd.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 248
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Spell out
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] City
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] [PII]. And what is the state?
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Can you verify the state? [PII] and the state is?
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] OK. [PII], right?
[AGENT][NEUTRAL] Yes, you can spell it out or the abbreviation for the state is OK, like the letters OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. That, I will repeat the address [PII] and the OK.
[CUSTOMER][NEUTRAL] And the zip code is [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And what is the primary care you be appeal timely filing?
[AGENT][NEUTRAL] There there is no timely filing, um, and we, this is additional information, so once we receive it, we'll continue processing.
[CUSTOMER][POSITIVE] OK. Thank you so much. Can you give me the qualify number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Sure, so 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. Your name and two digits, right?
[AGENT][NEUTRAL] It was, was there anything else?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much. Have a nice day.
[AGENT][POSITIVE] You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye