AccountId: 011433970860
ContactId: 926e1438-305a-4fcc-abaa-97cb8faa574f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209479 ms
Total Talk Time (AGENT): 93561 ms
Total Talk Time (CUSTOMER): 51258 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/926e1438-305a-4fcc-abaa-97cb8faa574f_20250128T16:20_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] Um, hi, [PII]. This is [PII] calling from the provider's office to check on a claim status.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status, um, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEGATIVE] And it decline.
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today, [PII]?
[CUSTOMER][NEUTRAL] Mm, one.
[AGENT][NEUTRAL] OK, may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure. It is 01813684.
[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] Mhm.
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] Mhm. So, so this is for [PII] for the amount of $48 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It is MSC physicians.
[AGENT][NEUTRAL] OK, hold on one moment. The reason I'm hesitant.
[AGENT][NEUTRAL] It's $48.
[AGENT][NEUTRAL] The complete total bill, could it be any other total bill? We have a claim here, but it's a different total bill, that's why I'm asking.
[CUSTOMER][NEUTRAL] So this is only for $48 evening.
[AGENT][NEUTRAL] OK, so if that's the case, then there's no claim here on that data service for your um claim.
[CUSTOMER][NEUTRAL] May I know the patient's uh eligibility?
[AGENT][NEUTRAL] Sure, so the policy has been active since [PII].
[CUSTOMER][NEUTRAL] So is it the PRID 60801?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Hold on one moment. You said 60801 for our payer ID? Not for this product. Hold on one second, let me make sure.
[CUSTOMER][NEUTRAL] Oh, yes.
[AGENT][NEUTRAL] I just want to make sure with the type of product they have. There's 2 places they can go, so I just want to make sure.
[AGENT][NEUTRAL] OK, so yes, 60801 is the correct payer ID for their product.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] So then that's it for the day and thank you so much and may I know the reference number for conversation?
[AGENT][NEUTRAL] Sure, there's no call reference number, but you can use my name and today's date. First initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much and you may have a wonderful rest today bye bye.
[AGENT][POSITIVE] Thank you, [PII]. You also, and thanks for calling APO. Bye bye.