AccountId: 011433970860
ContactId: 7777bd3b-1cf5-40f3-8bcf-9669b4276803
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 454489 ms
Total Talk Time (AGENT): 121382 ms
Total Talk Time (CUSTOMER): 195645 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/7777bd3b-1cf5-40f3-8bcf-9669b4276803_20250605T13:19_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling for provider to check on the claim status. Please be informed that this call is being recorded and for training and quality purposes. May I know if I can help you with the patient information on the provider information?
[AGENT][NEUTRAL] Can I have the spelling of your name and the callback number?
[CUSTOMER][NEUTRAL] Sure. It is [PII] and the callback number will be [PII]. No extension direct line.
[AGENT][NEUTRAL] Thank you [PII], what is the policy number of the member that you're calling to verify the claim status for?
[CUSTOMER][NEUTRAL] Just a moment. So the policy number will be.
[CUSTOMER][NEUTRAL] 02513096.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] You don't want to do so
[CUSTOMER][NEUTRAL] Sure, the patient first name is [PII] and the last name is [PII], and the date of birth will be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and you're calling to check the status of a claim for Destiny for what date of service?
[CUSTOMER][NEUTRAL] Uh, the date of service was [PII] with the total charges of $216.30.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That's correct. No, [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] There's no claim on file for [PII].
[CUSTOMER][NEUTRAL] OK, uh, let me check. OK, so we have somebody that came electronically and we have sent it to the payer ID 57,080.
[AGENT][NEUTRAL] Or Destiny.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And see, what was that electronic payer ID that you submitted that claim to?
[CUSTOMER][NEUTRAL] It was 57,080.
[AGENT][NEGATIVE] That is incorrect. It is 64556.
[CUSTOMER][NEUTRAL] Uh, 645-5. OK, got it. And let me go ahead and confirm the mailing address. Is it [PII]?
[AGENT][NEUTRAL] No.
[AGENT][NEGATIVE] That is incorrect as well.
[CUSTOMER][NEUTRAL] OK, so what will be the current mailing address?
[AGENT][NEUTRAL] The mailing address, it will be addressed to [PII], and the the mailing address is [PII]. That's [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK, got it. And uh
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEGATIVE] Uh F A.
[CUSTOMER][NEUTRAL] OK, um, is the patient active in the data service?
[AGENT][NEUTRAL] member's policy has been active since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, still active.
[CUSTOMER][NEUTRAL] And uh you're the primary for the patient, is that correct?
[AGENT][NEUTRAL] Um, this is not a primary insurance company.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] So the patient.
[AGENT][NEUTRAL] We're not affiliated with any other one, but this is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] It's only having one insurance.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah, just a moment. I'm making a small note uh of what we're talking just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so, uh.
[CUSTOMER][NEUTRAL] So you must not be having any information on the coordination of benefits.
[AGENT][NEUTRAL] No, the coordination of benefits will be standard, but um we don't have any information about another insurance company.
[AGENT][NEGATIVE] We won't be affiliated with it.
[CUSTOMER][NEUTRAL] Got it. So.
[CUSTOMER][NEUTRAL] And what is the claim submission timely filing?
[AGENT][NEGATIVE] There's no timely filing, [PII].
[CUSTOMER][NEGATIVE] OK, no timely filing got it.
[CUSTOMER][NEUTRAL] And um what will be the preferred mode of submission?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Repeat yourself.
[CUSTOMER][NEUTRAL] I was just asking what will be the preferred mode of submission like uh you preferred it via mail or electronically.
[AGENT][NEUTRAL] Whichever you prefer.
[AGENT][NEUTRAL] I mean we're gonna get the claim either way if you send it by mail or electronically we.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Claim will be received and processed as long as it's the correct information that you're sending it over to.
[CUSTOMER][NEUTRAL] Got it. So, um, can you please spell your name?
[AGENT][NEUTRAL] [PII], and today's date is a reference because we don't provide reference numbers.
[CUSTOMER][NEUTRAL] OK, got it, so it will be 06052025, is that correct?
[AGENT][NEUTRAL] What is the, what number are you providing?
[CUSTOMER][NEUTRAL] Uh, today date I was just confirming the call reference number.
[AGENT][POSITIVE] Yes, that's correct. Mhm, yes, that is correct.
[CUSTOMER][NEUTRAL] OK. And, and I just wanted to ask like for how many claims you can help me in the call?
[AGENT][NEUTRAL] Um, how many clients do you have?
[CUSTOMER][NEUTRAL] Actually, I was having 8 games with me.
[AGENT][NEUTRAL] Mhm, OK, so I can help you with the next one. What is the policy number?
[CUSTOMER][NEUTRAL] Sure, the policy number is 02581622.
[CUSTOMER][NEUTRAL] You said it.