AccountId: 011433970860
ContactId: 97b397a9-b283-4fa6-9c8b-a14868549bf5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276179 ms
Total Talk Time (AGENT): 118913 ms
Total Talk Time (CUSTOMER): 122204 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/97b397a9-b283-4fa6-9c8b-a14868549bf5_20250326T21:16_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] Hi, Ms. [PII]. My name is [PII] and I'm calling from um Val Clinic, and I need assistance with the claim, please.
[CUSTOMER][NEUTRAL] I think we're listed as VVMC um diversified services.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, you need a claim status?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the claim status. And Ms. [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure, it is [PII].
[CUSTOMER][NEUTRAL] And the policy number is I just had it up.
[CUSTOMER][NEUTRAL] Oh, let me look at the card.
[CUSTOMER][NEUTRAL] 02312747.
[AGENT][POSITIVE] 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] Sure, it is [PII], and her 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 for the claim and the total bill?
[CUSTOMER][NEUTRAL] Sure, now I need to open the claim back out. I apologize.
[AGENT][POSITIVE] Oh, no, you're fine. Take your time.
[CUSTOMER][NEUTRAL] OK, is data service 128 of 2025 in the amount of $345?
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And it's [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm not showing a claim on file for [PII] for [PII].
[CUSTOMER][NEUTRAL] OK, is her policy still active?
[AGENT][NEUTRAL] You know what?
[AGENT][NEUTRAL] Hold on one moment. So this particular policy.
[AGENT][NEUTRAL] Didn't become effective until [PII]. The policy before it was active until [PII]. So let me look at that one and see if the claim might be there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, um, let me also get, did you need that policy number as well?
[CUSTOMER][NEUTRAL] Yeah, well, I see why I asked that because I see another number 369.
[CUSTOMER][NEUTRAL] 46503 with 4 leading zeros.
[AGENT][NEUTRAL] No, so there um the the policy number is 193.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9232.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me see if that's there [PII].
[AGENT][NEUTRAL] Wait.
[CUSTOMER][NEGATIVE] I'm a bit confused now.
[AGENT][NEUTRAL] Yeah, now I just confused myself. I'm sorry. This was the active policy. There's no, there's no policy on, there's no claim on file. I'm sorry.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] So which is the right policy, the 1939232?
[CUSTOMER][NEUTRAL] For that data service.
[AGENT][NEUTRAL] No, no, no, no, the correct policy number would be 2312747, the one that you gave me, um.
[CUSTOMER][NEUTRAL] OK, 231-274. OK, yeah, OK, the one that I had the card for, OK.
[AGENT][NEUTRAL] Yes, there's just no claim on file for that. The February mixed me up. I'm sorry.
[CUSTOMER][NEUTRAL] And you
[CUSTOMER][NEUTRAL] Oh, OK, and just let me look back at the card and one verify everything that's on it. I swear I can't see right now. My, my glass is saying it's time for you to just stop today. Insurance card.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, yeah, [PII] family 02312747. So the claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII] City, [PII], OK.
[CUSTOMER][NEUTRAL] Alright, I will have that updated and.
[AGENT][NEUTRAL] And we also have
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] We also have a fax number and a payer ID if you need it as well.
[CUSTOMER][NEUTRAL] OK, give me the fax number. Maybe I'll just fax it.
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] And that's attention APL claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All righty. Thank you so much. And may I get a reference number for this call?
[AGENT][NEUTRAL] Sure, sir, there's no call reference number, but you can use my name and today's date, and again that's [PII] to my last name is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right, thank you so much and have a great day. Bye bye.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.