AccountId: 011433970860
ContactId: 9873951d-5390-4a05-bcb7-329a4222ea8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 481950 ms
Total Talk Time (AGENT): 135211 ms
Total Talk Time (CUSTOMER): 114982 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/9873951d-5390-4a05-bcb7-329a4222ea8a_20250310T17:35_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, [PII]. My name is [PII]. I need to check on a claim. Can you please help me on this?
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yes, I'll be more than happy to help you with the claim status, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I do have the policy number, [PII], that is.
[CUSTOMER][NEUTRAL] 02389382.
[AGENT][NEUTRAL] 023, did you say 893?
[CUSTOMER][NEUTRAL] 02389382.
[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] Uh-huh.
[CUSTOMER][NEUTRAL] Yes, member's first name, [PII], [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. May I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] Uh [PII] and the bill amount is $387 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] So I'm not showing a claim on file for [PII]. Let me see if there's another.
[AGENT][NEUTRAL] Oh no, this is the only medical policy. So there's no claim on file for that date of service, and it was on [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, yeah, that's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I just want to make sure so I can double check it for you. No, there's no claim on file.
[CUSTOMER][NEUTRAL] You don't have a claim on?
[AGENT][NEUTRAL] But you can file at any time. There is no timely filing. Um, let me make sure the policy was active though.
[AGENT][NEUTRAL] Yeah, the policy, the policy has been active since [PII], so you can file still.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] stated there was no claim on file, right?
[AGENT][NEUTRAL] Right, no claim on file.
[CUSTOMER][NEUTRAL] I'm on [PII].
[CUSTOMER][NEUTRAL] Particular data service and.
[CUSTOMER][NEUTRAL] What is the billing address?
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] You said the patient effective date is [PII], correct?
[AGENT][NEUTRAL] Um, yes, let me double check it. Hold on one moment. Let me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, the policy has been active since [PII].
[CUSTOMER][NEUTRAL] To still active, is there not timing limit, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What is the payer ID?
[AGENT][NEUTRAL] The pay ID is 60801.
[CUSTOMER][NEUTRAL] Addressive 8 OTF for. What is the reference number for this call?
[AGENT][NEUTRAL] So there's no call reference number. You can use my name in today's date, which is [PII] is [PII].
[CUSTOMER][NEUTRAL] Give me one minute. I have one more patient, [PII]. Can you please help me on this last patient?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] When you're ready, I can go ahead.
[AGENT][POSITIVE] Oh, I'm ready. I was waiting for you. Go ahead. I'm I'm ready.
[CUSTOMER][NEUTRAL] OK. Just give me one minute. I thought you're uh checking on it. Uh, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, we're waiting for the policy number for the next member.
[CUSTOMER][NEUTRAL] Can you please give me one?
[CUSTOMER][NEUTRAL] Yeah. Just give me one minute.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thanks a lot.
[CUSTOMER][NEUTRAL] Sorry for the delay. Hold on. My system is loading.
[AGENT][POSITIVE] Oh, you're fine. Take your time.
[CUSTOMER][NEUTRAL] OK. And uh next number ID is?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 023
[CUSTOMER][NEUTRAL] 893-887.
[AGENT][NEUTRAL] OK, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, member's first name is [PII], [PII], date of birth.
[AGENT][NEUTRAL] Thank you for that. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Total bill amount, $17,810.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] [PII] bill amount, $17,810. Do you have a claim on file?
[AGENT][NEUTRAL] Uh uh
[AGENT][NEUTRAL] Give me just a minute. I was gonna let you know there is no claim on file. I was just confirming the date of service to make sure.
[AGENT][NEUTRAL] There's no claim on file for your date of service of [PII], but you can still file the claim.
[CUSTOMER][NEUTRAL] OK. Give me a minute.
[CUSTOMER][NEUTRAL] What is the patient's effective date on this policy?
[AGENT][NEUTRAL] The policy has been effective since [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is the effective date for the policy, yes.
[CUSTOMER][NEUTRAL] Mailing address effective date. OK, thank you and bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day.