AccountId: 011433970860
ContactId: 9066c069-45e5-4235-9213-90fe990b5630
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 567200 ms
Total Talk Time (AGENT): 158541 ms
Total Talk Time (CUSTOMER): 176367 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/9066c069-45e5-4235-9213-90fe990b5630_20250102T16:50_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] Yeah
[CUSTOMER][NEUTRAL] Yeah, this is [PII] calling from provider site. I want to know claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, [PII], and how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Only 2.
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected and the first member's policy number?
[CUSTOMER][NEUTRAL] Yeah, contact number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Policy member name is [PII], first name, second name [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK, hold on one moment. I need the policy number so I can pull up the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy number is AC.
[CUSTOMER][NEUTRAL] 0527.
[AGENT][NEUTRAL] OK, um, that might be their major insurance. Do you have their APL insurance information?
[CUSTOMER][NEUTRAL] Yeah, which information?
[AGENT][NEUTRAL] If you have their APL um ID card, we're looking for the in-hospital or outpatient policy cert number.
[AGENT][NEUTRAL] Our policies usually start with a 01 or 02.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a second. I will check. Just a moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, hello?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes I'm here.
[CUSTOMER][NEUTRAL] Hello? Yeah, you want to know APL number means previous?
[AGENT][NEUTRAL] Yes, I'm asking you for the APL policy number. The policy number that you gave is not for APL. Our policies don't start with the letter. It should start with a 01 or 02.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 01 with or 02. Just a moment, I check all policy card.
[AGENT][NEUTRAL] OK. Or if you'd like to repeat the first and last name, I can try to look with the name as well.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please check. I tell you. Just a minute. Yeah, first name is [PII], [PII].
[CUSTOMER][NEUTRAL] And last name is [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let me see.
[AGENT][NEUTRAL] Hold on one moment, I'm just waiting for the policies to populate here.
[CUSTOMER][POSITIVE] No issue. You can take time.
[AGENT][NEUTRAL] And [PII], can you verify [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yeah, I'll tell you just a moment. Date of birth is
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And she has one active policy, which is the cancer policy. Um, what's the date of service for the claim?
[CUSTOMER][NEUTRAL] Yeah, I tell you.
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][NEUTRAL] All right, and all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment while I look for that claim for you.
[AGENT][NEUTRAL] And for [PII], there is no claim on file for that data service.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, there is no claim on file.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] OK. Just I want to confirm this. And your mailing address is, this is [PII]. It's correct?
[AGENT][NEUTRAL] No, that's not correct. That's the old claims mailing address. Let me give you the correct mailing address.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah, please tell me. Yeah.
[AGENT][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. May I know this claim TF TFL of this claim?
[AGENT][NEUTRAL] There's no timely filing limit. You can file the claim at any time as long as the policy was active on the data service. Um, this is a cancer policy though. What what is trying to be, what are you filing? Do you mean for the medical policy?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, medical policy for coinsurance amount.
[AGENT][NEUTRAL] OK, um, she only has an active cancer policy. Her medical policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no, sorry. Yeah, this is active for and this is regarding for cancer policy.
[AGENT][NEUTRAL] And let me give you that policy number.
[CUSTOMER][NEUTRAL] Because he
[CUSTOMER][NEUTRAL] Hey [PII].
[AGENT][NEUTRAL] The policy number is 83401.
[CUSTOMER][POSITIVE] OK, policy number. OK. Thank you for this.
[CUSTOMER][NEUTRAL] OK. May I know call reference number for this?
[AGENT][NEUTRAL] Sure, so there's no call reference number. You can use my name for the whole call, it will be my name and today's date, that's [PII] is [PII], and then today's date.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I need the claim number, status of the claim, and the date.
[CUSTOMER][NEUTRAL] Of
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][POSITIVE] OK. That's fine. Thank you for this. Thank you for your help. Have a nice day.
[AGENT][NEUTRAL] You're very welcome. I mean, you said you had two claims. Is this, is this the only one?
[CUSTOMER][NEGATIVE] Yeah, uh, I checked got to other claim is balance is on very low 31 cents only. OK, and it's not for you to go for.
[AGENT][NEUTRAL] All right, well, was there anything else I could assist you with today?
[CUSTOMER][NEGATIVE] No thank you. I see.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL and happy New Year.
[CUSTOMER][NEUTRAL] Yeah.