AccountId: 011433970860
ContactId: 8824a3f6-b32d-4226-bd2b-5242c0c8d289
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301670 ms
Total Talk Time (AGENT): 78191 ms
Total Talk Time (CUSTOMER): 125357 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/8824a3f6-b32d-4226-bd2b-5242c0c8d289_20250611T17:04_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling on behalf of provider's office to check on a claim status. How are you doing today, [PII]?
[AGENT][POSITIVE] I'm good.
[AGENT][POSITIVE] And I'd be happy to assist with claim status today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Sure, the callback number is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is 02556462 M as in Mary, L as in Lima 7.
[AGENT][NEUTRAL] I'm sorry, can you repeat the numbers again for me please?
[CUSTOMER][NEUTRAL] Sure. It's 02556462 M as in Mary, L as in Lima, 7.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Uh, inpatient?
[CUSTOMER][NEUTRAL] Claim status.
[AGENT][NEUTRAL] And what's the date of service?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] And what's your tax ID?
[CUSTOMER][NEUTRAL] The tax ID is
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm not sure we have that claim on file.
[CUSTOMER][NEUTRAL] Mhm. Uh, could you please verify the claim has been billed through PayPal on [PII] to the mailing address [PII]. Is the address is correct?
[AGENT][POSITIVE] Yes, that, that's correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So no claim and pay, right?
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Is, is there any payer ready to submit the claim?
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] Thank you. The payer name, please?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. Now, insurance name?
[AGENT][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] Uh, thank you. The member ID what I have provided is the correct one, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh, is there any group ID number?
[AGENT][NEUTRAL] The group ID is.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 80094.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, could you please provide me the patient plan type, please?
[AGENT][NEUTRAL] It's a gap policy.
[CUSTOMER][NEUTRAL] Your policy. Could you please provide me the timely filing limit, please?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] Um, could you please provide me the plan effective and termination date, please?
[AGENT][POSITIVE] Plan was effective on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And 24 and still active, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh, could you please provide me the call reference number, please?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I can assist with today?
[CUSTOMER][POSITIVE] No, thank you also, sir. Thank you for your assistance. Have a great day.
[AGENT][POSITIVE] Thank you for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm bye bye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] PMR.