AccountId: 011433970860
ContactId: 866be326-722a-4ee7-923a-847919a0eb65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 409660 ms
Total Talk Time (AGENT): 108879 ms
Total Talk Time (CUSTOMER): 88196 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/866be326-722a-4ee7-923a-847919a0eb65_20250530T21:44_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from Pado's office to check our claim.
[AGENT][NEUTRAL] OK, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]. Di direct line, no [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Member's ID will be 02443376.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you for verifying that and then what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The amount is $288.55.
[AGENT][POSITIVE] Got it thank you one moment.
[AGENT][NEUTRAL] OK, and this was with uh Eli imaging?
[CUSTOMER][NEUTRAL] Yup.
[AGENT][NEUTRAL] OK, yeah, so we did receive this claim uh looks like we're just missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK, so you want the primary EOB?
[AGENT][NEUTRAL] That's correct. This is a secondary medical policy.
[CUSTOMER][NEUTRAL] To process the claim.
[CUSTOMER][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] So how we can send you the primary or we should uh we need to rebuild the claim electronically?
[AGENT][NEUTRAL] No, you don't have to do that. So we have the claim information already if you just wanna send that primary EOB. I have a mailing address and a fax number I can give you.
[CUSTOMER][NEUTRAL] OK. So, may I know, yeah, I will take that. May I know on which date you have received the claim?
[AGENT][NEUTRAL] Of course that was uh [PII].
[AGENT][NEUTRAL] And it completes processing on [PII].
[AGENT][NEUTRAL] And I've got that claim number for you as well if you need that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is 36.
[CUSTOMER][NEUTRAL] So what is the fax number?
[AGENT][NEUTRAL] Oh, sorry, um, fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] OK. And uh what is the claim number?
[AGENT][NEUTRAL] Yes, 3605615.
[CUSTOMER][NEUTRAL] OK. And what is the like uh appeal filing limit like to send the document? AFL?
[AGENT][NEGATIVE] There is no timely filing limit for missing information.
[CUSTOMER][NEUTRAL] OK. Call reference number for this one so we can check for another one.
[AGENT][NEUTRAL] Uh, reference number would be the same for any that we check. It would be my first name, last initial, and today's date. Uh, so my name is spelled [PII] [PII], and uh uh you said we had another claim to check. Was this for the same member, [PII]?
[CUSTOMER][NEUTRAL] Um, for the same member. No, it's for the another member.
[AGENT][NEUTRAL] Different number, OK, give me just a moment I'll let you know when I'm ready for that next policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] OK, I appreciate your patience. [PII], you can go ahead and give me that policy number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The policy number is 02313790.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for this number please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] One moment please, I apologize.
[AGENT][NEUTRAL] OK and then what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] [PII]. The amount is $522.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, I apologize that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we have not.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello, hello, hello, hello, hello, hello, hello, hello, hello, hello.
[CUSTOMER][NEUTRAL] Hello?