AccountId: 011433970860
ContactId: 800c89ad-212d-4274-8d31-1fa58b9b2090
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 637320 ms
Total Talk Time (AGENT): 146312 ms
Total Talk Time (CUSTOMER): 241008 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/800c89ad-212d-4274-8d31-1fa58b9b2090_20250522T16:22_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII]. I'm calling from Jackson Moor Health to check the claim status. Could you please go for that?
[AGENT][NEUTRAL] Sure, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] [PII], sir.
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] OK, the policy number is
[CUSTOMER][NEUTRAL] Uh, wait a second. The policy number is 024.
[CUSTOMER][NEUTRAL] 563-91.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yes, the callback number is [PII].
[AGENT][NEUTRAL] I'm sorry, it sounds like it's missing a number. Can you give that to me again, please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK. And verify the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The patient's name is uh wait a second.
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[CUSTOMER][NEUTRAL] And then.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] The date of service is
[CUSTOMER][NEUTRAL] Uh, uh, [PII] and the bill amount is $968 and even.
[AGENT][NEUTRAL] Give that data service to me again, please.
[CUSTOMER][NEUTRAL] And may I get your name, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII].
[CUSTOMER][NEUTRAL] [PII]. And may I get your name, please?
[AGENT][NEUTRAL] Sure, it's [PII], spelled [PII], do you have the balance after primary process the claim?
[CUSTOMER][NEUTRAL] It's kicking
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] Please uh repeat that again.
[AGENT][NEUTRAL] Do you have the balance after the primary insurance has processed the claim?
[CUSTOMER][NEUTRAL] Yes, the balance is $50 as a co-pay.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] I do not show we received a claim for that data service. Can you verify the address it was submitted to?
[CUSTOMER][NEUTRAL] OK, you've not received any claims for the date of service, right?
[AGENT][NEUTRAL] Correct. We have not received the claim. Can you verify the mailing address the claim was submitted to?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What was the member's effective the termination date?
[AGENT][NEUTRAL] Well, that policy number you gave terminated [PII]. They do have a current policy number and give that to you when you're ready.
[CUSTOMER][NEUTRAL] OK, uh, wait a second. Um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Wait a second.
[CUSTOMER][NEUTRAL] OK, uh, there is no claim on file.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, what are, could you please repeat the effective, it's from [PII].
[AGENT][NEUTRAL] Correct. The current policy number I can give to you, that policy became effective [PII] and is active.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, what was the correct, ma'am, ID?
[AGENT][NEUTRAL] It is 257-888-1.
[CUSTOMER][NEUTRAL] 257-888-1.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, 257-888-1, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What was the timely firing limit to some client?
[AGENT][NEGATIVE] Uh, there's no timely filing.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. What was the mailing address to some a plan?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it's [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. What was the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 0801.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Or like a minute.
[CUSTOMER][NEUTRAL] 734 OK.
[CUSTOMER][NEUTRAL] What was the call reference number?
[AGENT][NEUTRAL] Uh, you may use my name in today's date, and it's [PII], last initial [PII]
[CUSTOMER][NEGATIVE] Yeah, I didn't do.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hey, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, I have another client. Could be able to assist me with that?
[CUSTOMER][NEUTRAL] OK, the
[AGENT][POSITIVE] OK, uh thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] I, I have, I have another on time.
[AGENT][NEUTRAL] For the same patient or a different patient?
[CUSTOMER][NEUTRAL] Different patient.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] get on my nerves. Oh my gosh.
[AGENT][NEUTRAL] OK, what is the next policy number, [PII]?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The next policy number is uh wait a second, it's loading.
[CUSTOMER][NEUTRAL] The next policy number is 016115.
[CUSTOMER][NEUTRAL] 65
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima, number 8.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient's name is uh [PII] and the date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, date of service, amount of the charge.
[CUSTOMER][NEUTRAL] OK. The date of service is [PII] and the bill amount is
[CUSTOMER][NEUTRAL] $880 and even.
[AGENT][NEUTRAL] Balance after primary.
[CUSTOMER][NEUTRAL] OK. Uh, what do you need? You need the primary?
[AGENT][NEUTRAL] What is the balance after the primary?
[CUSTOMER][NEUTRAL] $50 as a co-payer.
[AGENT][NEUTRAL] OK, I don't show we received this claim, so you might want to resubmit either mail, fax, or you can submit it electronically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So
[CUSTOMER][NEUTRAL] What are the effecting the termination date of the member?
[AGENT][NEUTRAL] Effective date [PII], policy is active.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm still active.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and it was the same.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] It was the same.
[CUSTOMER][NEUTRAL] Mailing address and the pay ID details.
[AGENT][NEUTRAL] Same mailing address and pay ID.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK, so same call reference number?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. OK, thank you.
[AGENT][POSITIVE] Mhm thank you for calling APL have a great day.
[CUSTOMER][POSITIVE] Thanks for asking.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, bye bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK.