AccountId: 011433970860
ContactId: 76516ec7-0cbf-4643-b44e-b27e6fe95598
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347799 ms
Total Talk Time (AGENT): 83424 ms
Total Talk Time (CUSTOMER): 155593 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/76516ec7-0cbf-4643-b44e-b27e6fe95598_20250609T13:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was, uh, my name is [PII]. Um, good morning. I'm calling from Advanced Multi Specialty Medical Services, and I was calling for about one of your members. Uh, I'm not sure if this is a gap insurance for him, but we sent something through the mail and it was returned to us.
[CUSTOMER][NEUTRAL] He submitted the claim to you through the mail. It was returned to us.
[AGENT][NEUTRAL] OK, I'm sorry, you said your name is [PII]?
[CUSTOMER][NEUTRAL] [PII] for the last name.
[AGENT][NEUTRAL] And your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. What is the policy number?
[CUSTOMER][NEUTRAL] It is 02300974 M as in Mary, L as in Larry 8.
[CUSTOMER][NEUTRAL] The member name is [PII].
[AGENT][NEUTRAL] OK thank you and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] OK. [PII], [PII].
[AGENT][NEUTRAL] OK, thank you for that verification. I have the member pulled up and you're calling in regards to a claim, is that correct? I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, we have a claim for data service 49-2025 and we send it through the mail to you. Did you receive that?
[AGENT][NEUTRAL] And what's the total bill charged for that date of service?
[CUSTOMER][NEUTRAL] Well, the total bill was $9490.
[CUSTOMER][NEUTRAL] And the patient responsibility that was supposed to come to you was $1,067.60.
[AGENT][NEUTRAL] OK, [PII]. 1 moment please.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I did not show that claim on file for the patient.
[CUSTOMER][NEUTRAL] OK, but, um, on that data service, are you the, you the secondary insurance or are you the gap insurance?
[AGENT][NEUTRAL] The secondary and the gap is the same thing, so we're his secondary insurance.
[CUSTOMER][NEUTRAL] OK, so what I needed to know is the correct address or can I submit this claim to you through email or can I send it, um, I have to send it through the mail.
[AGENT][NEUTRAL] You can mail it, you can fax it to us or you can send it electronically. I can verify mailing address to you.
[AGENT][NEUTRAL] Give you a fax number and payer ID.
[CUSTOMER][NEUTRAL] Oh, I don't have a face right now, but, um, OK, what is the payer ID?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK, can you repeat that 60.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] 60801. OK, thank you and may I have the address, mailing address?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It is
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, wait a minute. [PII].
[CUSTOMER][NEUTRAL] And what's the zip code?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] And the address is [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Am I correct?
[AGENT][NEUTRAL] No, it is [PII].
[AGENT][NEUTRAL] No, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, and this the claims you say what claims department?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, alright and uh thank you so very much. May I have a reference number?
[AGENT][NEUTRAL] You're welcome. We do not use reference numbers. [PII], you can use my name [PII] last initial is [PII] and today's date.
[CUSTOMER][NEUTRAL] Your name is [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No, I keep repeating the question because uh your phone going in and out.
[CUSTOMER][POSITIVE] OK, alright, thank you so very much for your help.
[AGENT][POSITIVE] Oh OK, I'm sorry about that.
[CUSTOMER][POSITIVE] OK, have a good day thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling EPO. You too, bye bye take care.
[CUSTOMER][POSITIVE] Thank you bye