AccountId: 011433970860
ContactId: 9410e145-d869-43de-b49f-24d7d78f0635
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380549 ms
Total Talk Time (AGENT): 141657 ms
Total Talk Time (CUSTOMER): 150414 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/9410e145-d869-43de-b49f-24d7d78f0635_20250501T17:41_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII], my name is [PII]. I'm calling with Roper Saint Francis Physicians, and we, I need to check and see if you all received a claim from us, please.
[AGENT][NEUTRAL] Oh, sure, I'll be more than happy to check and see if the claim is on file. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Oh sure, it's the number is [PII].
[CUSTOMER][NEUTRAL] And the policy number is D like David 43724131.
[AGENT][NEUTRAL] Alright, do you have a, uh, well,
[AGENT][NEUTRAL] Do you have a copy of the member's ID card?
[CUSTOMER][NEUTRAL] Um, let me see if he gave us one. Hold on just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have to get into his chart here a little bit.
[CUSTOMER][NEUTRAL] Oh, I believe he did. Let's see.
[AGENT][POSITIVE] Take your time. OK.
[AGENT][NEUTRAL] We're looking for an in-hospital or outpatient.
[CUSTOMER][POSITIVE] Oh yes ma'am. I believe that is.
[AGENT][NEUTRAL] Um, on the card you're looking for in-hospital or outpatient policy cert number. It should start with a 01 or 02?
[CUSTOMER][NEUTRAL] Oh, that's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I see the pharmacy. I see.
[CUSTOMER][NEUTRAL] Vision
[CUSTOMER][NEUTRAL] Uh, I see a group number.
[AGENT][NEUTRAL] Oh, wait a minute.
[AGENT][NEUTRAL] If you see vision on it, he probably, that's probably the um employer card with all the benefits because we don't provide vision. Um, do you have a full social for the member? So basically, that the number is for 90 degree benefits, so we can't use that in our system. That's what's going on here.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Oh, I got you. Alright, let me see if he gave us a social. 00, he did not. Oh no, he did, yeah, yeah, yeah, OK, it's perfect, thank you. I'm sorry for the confusion, um, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I can look it up. You got it? OK.
[AGENT][NEUTRAL] Yeah, fine.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And may I have the member's first and last name?
[CUSTOMER][NEUTRAL] Yes ma'am, it's for [PII].
[AGENT][NEUTRAL] Here we go, hold on one moment.
[CUSTOMER][POSITIVE] Well, you found them, so that's a positive step. I'm going to take that.
[AGENT][NEUTRAL] And I'm gonna give you the um policy number also. Can you verify his date of birth for me?
[CUSTOMER][NEUTRAL] Yes, ma'am. It 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?
[CUSTOMER][NEUTRAL] Yes, it is for [PII] for $372 even please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And this is for his medical policy, right?
[CUSTOMER][NEUTRAL] Mhm, yes, ma'am. Um, looks like it's a secondary to his United Healthcare Medicare plan.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Mhm, yes ma'am for um 372, yes.
[AGENT][NEUTRAL] OK, so, um, we're not showing a claim on file for that data service.
[CUSTOMER][NEUTRAL] Alright, I am not surprised since we have the now.
[CUSTOMER][NEUTRAL] We have that D number as his ID number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is that incorrect?
[AGENT][NEUTRAL] Yeah, well, for APL it is.
[CUSTOMER][NEUTRAL] OK, which one should we submit on the claim?
[AGENT][NEUTRAL] So let me give you the APL policy. Um, so it's 220.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4547.
[CUSTOMER][NEUTRAL] 2204547 and is that the number that we should submit on the on the claim instead of the the number?
[AGENT][NEUTRAL] Yes, ma'am, that that um that is APL's policy number, so it'll pull right up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, perfect.
[AGENT][NEUTRAL] And then the claims, did you need?
[CUSTOMER][NEUTRAL] And let me make sure since you.
[CUSTOMER][POSITIVE] Yes, you knew exactly where I was going go right ahead. I'm sorry.
[AGENT][NEUTRAL] It's OK. Um, did you need the mailing address or the payer ID?
[CUSTOMER][POSITIVE] Yes ma'am, the mailing address would be great.
[AGENT][NEUTRAL] OK, so the claims go to IMA like Igloo, Mary Alpha.
[AGENT][NEUTRAL] And the mailing address is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][POSITIVE] OK, and I think our system is having trouble sending this one electronically so thank you for the address. I think I am gonna have to mail it to you guys and I need to put that APL number on it, right? I just wanna make sure that I have all my ducks in a row and OK so you guys can find it perfect um if you don't mind to give me a call reference number you've been so helpful thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, yes, ma'am.
[AGENT][NEUTRAL] You're very welcome. I'm glad I could assist you. So we don't have call reference numbers, but you can use my name and today's date. And again, that's [PII] my [PII] is [PII].
[CUSTOMER][POSITIVE] Perfect, thank you so much you have a lovely afternoon.
[AGENT][POSITIVE] Thank you, [PII]. You also, was there anything else I can help with?
[CUSTOMER][POSITIVE] No ma'am, I'm gonna get this one mailed out the door. Thank you.
[AGENT][POSITIVE] Alright, you're welcome. Thanks for calling APL. Have a great day and a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.