AccountId: 011433970860
ContactId: 93f311cf-64bd-4965-9812-0c25d0e0def7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 771419 ms
Total Talk Time (AGENT): 148572 ms
Total Talk Time (CUSTOMER): 226974 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/93f311cf-64bd-4965-9812-0c25d0e0def7_20250320T17:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling AL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, sir. Uh, good morning. This is [PII] calling from provider office. How are you doing today?
[AGENT][NEUTRAL] I'm good, [PII]. How are you?
[CUSTOMER][NEGATIVE] I'm bored actually, I need this lunch later.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on a claim for you today. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Uh-huh. Policy number, just wait a moment. Uh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, policy number for this patient is 02443441.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, they will.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] So?
[CUSTOMER][NEUTRAL] Date of birth, uh, it's [PII].
[AGENT][POSITIVE] Thank you for that and [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] Just wait a minute. Hold on.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] Thank you for that. And then what's the date of service?
[CUSTOMER][NEUTRAL] Uh, sorry, can you repeat again?
[AGENT][NEUTRAL] Can I have the date of service?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII]. Total bill amount $380.
[AGENT][NEUTRAL] OK, I'm not showing any claims on file for that date of service.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Correct, I searched [PII]. I'm not showing anything on file.
[CUSTOMER][NEUTRAL] Uh, can you pull up another one, data service?
[CUSTOMER][NEUTRAL] Sorry, it's different patient.
[CUSTOMER][NEUTRAL] Can you pull up another one?
[AGENT][NEUTRAL] So it's a different policy number?
[CUSTOMER][NEUTRAL] Uh, yes, different policy.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Same tax ID.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Uh, policy number.
[CUSTOMER][NEUTRAL] That's it um
[CUSTOMER][NEUTRAL] 004 0031729.
[AGENT][NEUTRAL] 40031729
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that as a policy number.
[CUSTOMER][NEUTRAL] Are you in Department of American Insurance?
[AGENT][NEUTRAL] We're American public life.
[CUSTOMER][NEUTRAL] American public life. But uh,
[CUSTOMER][NEUTRAL] Medicare paid amount it's 59 cross over this claim to American public life.
[AGENT][NEUTRAL] OK, do you have the member's name or social we can check that way or a claim number?
[CUSTOMER][NEUTRAL] Uh-huh. member name none Clark and uh social security number.
[AGENT][NEUTRAL] So what's the social?
[CUSTOMER][NEUTRAL] Uh, social, it's [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] What's the patient's first and last name again?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII], it's first name, and [PII], it's last name, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that didn't come up with anything. Let me try the name.
[AGENT][NEUTRAL] [PII] is the last name. [PII] is the first name, [PII], is that what you had said?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] First name, [PII]
[AGENT][NEUTRAL] What state does the patient live in?
[CUSTOMER][NEUTRAL] Date of service, it's [PII].
[AGENT][NEUTRAL] Do you know what state they live in?
[CUSTOMER][NEUTRAL] State taxes.
[CUSTOMER][NEUTRAL] Just wait a moment.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK. What's her date of birth?
[CUSTOMER][NEUTRAL] Date of birth, it's uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEGATIVE] I'm not able to find a member's policy that matches that information.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] 3 more claims for the same patient, Medicare cost our claim for this patient.
[AGENT][NEUTRAL] OK, I can't unfortunately find a policy. I need, I would need to find a policy to be able to check a claim. I can't find a policy number that matches the member's information.
[CUSTOMER][NEUTRAL] Just wait a moment.
[CUSTOMER][NEUTRAL] Just do a double.
[CUSTOMER][NEUTRAL] Sure card.
[CUSTOMER][NEUTRAL] Policy number 400317 0040031726.
[AGENT][NEGATIVE] That doesn't come up in our system as a valid policy number.
[CUSTOMER][NEUTRAL] OK, just wait a moment.
[CUSTOMER][NEUTRAL] Can you pull up a previous patient?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] You would need to give me the policy number, please.
[CUSTOMER][NEUTRAL] I gave the policy number. I uh have no any policy for this 14003172629.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] I already gave all the information of this patient.
[AGENT][NEUTRAL] OK, and I apologize, [PII]. I've searched by their name and I've searched by that number and I can't find an active policy for the member.
[CUSTOMER][NEUTRAL] It's um his date of birth.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] Can you pull up previous claim? It's uh
[CUSTOMER][NEUTRAL] Greave.
[AGENT][NEUTRAL] I'm sorry, what is that?
[CUSTOMER][NEUTRAL] Can you pull up another one claim?
[AGENT][NEUTRAL] Another claim, a different person?
[CUSTOMER][NEUTRAL] Yes, different person.
[AGENT][NEUTRAL] OK, so what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] 024434441.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] there.
[AGENT][NEUTRAL] Date of birth.
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[AGENT][NEUTRAL] And what what do you need me to check on this one?
[CUSTOMER][NEUTRAL] Uh, actually Medicare pay.
[CUSTOMER][NEUTRAL] The amount for this claim and uh cross over this claim to scan the.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Give me status.
[AGENT][NEUTRAL] OK, so what's the date of service? Is it [PII]?
[CUSTOMER][NEUTRAL] No, no. [PII].
[AGENT][NEUTRAL] OK, so there are no claims on file for [PII].
[AGENT][NEUTRAL] We're the members secondary insurance, so nothing was submitted to us for that date of service.