AccountId: 011433970860
ContactId: 96837e69-a6fa-436f-8131-4eaedbd77714
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298100 ms
Total Talk Time (AGENT): 107664 ms
Total Talk Time (CUSTOMER): 69771 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/96837e69-a6fa-436f-8131-4eaedbd77714_20250422T14:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APLC. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider service on claim service.
[AGENT][NEUTRAL] So what did you, there's a lot of background noise that's making it hard for me to hear you. What was your name again?
[CUSTOMER][NEUTRAL] One moment, sorry for that. Hi, my name is [PII]. I'm calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Uh, I do have 3 claims to work on.
[AGENT][NEUTRAL] You said a claim status.
[AGENT][NEUTRAL] OK, [PII] and what is your callback number?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and marking the information provided will be a verification of benefits and not a guarantee of payment. You will use my name that I gave you along with today's date as your call reference number.
[AGENT][NEUTRAL] And if we do have the claims on file, you will, and you need a copy of the primary or excuse me, if you need a copy of our explanation of benefits, once you have the claim number you can print that from our portal by going to secured.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the first patient's policy number?
[CUSTOMER][NEUTRAL] It's 02473107.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK, and any, uh, that's OK, so I believe I spoke to you a moment ago, [PII], regarding the same member. What is the member's name and date of birth?
[CUSTOMER][NEUTRAL] Member name is
[CUSTOMER][NEUTRAL] [PII] Last name is
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] office.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and while some information is still loading, what is the data service and total bill amount?
[CUSTOMER][NEUTRAL] So this is [PII] and the total amount is
[CUSTOMER][NEUTRAL] $39,216 and even.
[AGENT][NEUTRAL] OK, so again, we do not have a claim for that billed amount on that data service and the claim number that you gave me earlier is not for that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, hold on to the next claim. Let me check.
[AGENT][NEUTRAL] That's what I explained to you before, before you.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh yes, the next member ID is going to be
[AGENT][NEUTRAL] OK, so just a moment. I'm not ready for that one yet. No, sir, just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So on that claim for her, you just need to verify what the correct date of service is to match that claim number you provided.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the next member's data service, I mean, excuse me, policy number first.
[CUSTOMER][NEUTRAL] It's 015710349 M as in Mike, L as in Lime number 7.
[AGENT][NEUTRAL] OK, so that's gonna be two numbers. 015710349 is what you just said. That's too many numbers.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's not a valid policy number for APL.