AccountId: 011433970860
ContactId: 7f2bc6c3-6624-48b2-941c-6adadf7ff47d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205419 ms
Total Talk Time (AGENT): 103330 ms
Total Talk Time (CUSTOMER): 57293 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/7f2bc6c3-6624-48b2-941c-6adadf7ff47d_20250411T14:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning. This is [PII] I'm calling from Forward and to [PII]. I was just calling to follow up on the claim status.
[AGENT][NEUTRAL] OK, I can definitely help you with the claim status. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, yes, it's 02097908.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] Uh, 6:38.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so so the claim was received on [PII]?
[CUSTOMER][NEUTRAL] [PII]? OK.
[AGENT][NEUTRAL] The claim
[AGENT][NEUTRAL] The claim number is 3579009.
[AGENT][NEUTRAL] And on [PII], the claim is in a holding status. Um, we're waiting eligibility for benefits in a card. Once we receive that information, we can continue processing the claim. Um, so we have to
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Big is, uh, benefits in a card is aware of the process. Um, we just have to wait for the eligibility letting us know that they were active for coverage during your data service and then we can go ahead and process the payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK. Uh, does the patient have to contact you?
[AGENT][NEUTRAL] Or process the claim right there.
[AGENT][NEUTRAL] No, it's not, so we're waiting for that from benefits and a card. Um, I mean the member can contact benefits and a card if they'd like to, but uh there's really no turnaround. Just as soon as they send it to us, we continue processing, but we don't have like a turnaround or deadline for them.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, can I have.
[CUSTOMER][NEUTRAL] The reference number for this call please.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. And again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][POSITIVE] No, that was it. Thank you for your help.
[AGENT][POSITIVE] Alright, thanks for calling APL. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.