AccountId: 011433970860
ContactId: 98d35e3c-6726-4ceb-a67f-6fbe2acd28fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407720 ms
Total Talk Time (AGENT): 113251 ms
Total Talk Time (CUSTOMER): 102536 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/98d35e3c-6726-4ceb-a67f-6fbe2acd28fd_20250527T20:01_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I need the same information. Can you verify that for me?
[AGENT][POSITIVE] Yes, I'll be more than happy to assist you with the claims. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII] [PII].
[AGENT][NEUTRAL] OK, and [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] And you have only one claim?
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] with the extension [PII].
[CUSTOMER][NEUTRAL] The policy number is 60801.
[AGENT][NEUTRAL] So that's the payer ID. Do you have the member's ID card available?
[CUSTOMER][NEUTRAL] So, let me check one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And ma'am, I'm just checking.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check with the member name and date of birth?
[AGENT][NEUTRAL] Um, I can start with the member's first and last name.
[CUSTOMER][POSITIVE] Yeah, thank you for that.
[CUSTOMER][NEUTRAL] Yeah, my
[CUSTOMER][NEUTRAL] The last name is [PII].
[CUSTOMER][NEUTRAL] 0, sorry, [PII].
[CUSTOMER][NEUTRAL] And the first name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] The last name is [PII]
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][POSITIVE] [PII], yeah, that's correct.
[AGENT][NEUTRAL] First name is [PII]
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, um, it's been effective since [PII].
[AGENT][NEUTRAL] That policy number is 24499998.
[AGENT][NEUTRAL] And may I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] Yes, it's 517-2024 and the bill amount is $221 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, so I'm not showing a claim on file for [PII].
[CUSTOMER][NEUTRAL] Yeah, it is a crossover from
[CUSTOMER][NEUTRAL] I've made, do you, do you get.
[CUSTOMER][NEUTRAL] Do you have that claim? It is a crossover claim.
[AGENT][NEUTRAL] OK, I don't understand what you just said. Are you, are you asking me if there's another claim on file?
[CUSTOMER][NEUTRAL] No, no, no. It is a crossover claim.
[AGENT][NEUTRAL] OK, well,
[CUSTOMER][NEUTRAL] Still there is no claim on file on the date of service.
[AGENT][NEUTRAL] Right, there is no claim on file for [PII].
[CUSTOMER][NEUTRAL] Oh, OK. May I know the patient term date?
[AGENT][NEUTRAL] The policy is not terminated. Um, it's still active. It's been active since March, I'm just sorry, [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, may I know the TFL to submit the claim?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Timely filing limits.
[AGENT][NEUTRAL] There's no timely filing as long as the policy was active on the data service, you can file at any time.
[CUSTOMER][POSITIVE] Thank you. And can I, can, how we can send the uh claim?
[AGENT][NEUTRAL] Um, you can mail it, you can fax it.
[CUSTOMER][NEUTRAL] Mailing address or payer ID?
[AGENT][NEUTRAL] Our payer ID is 60801.
[CUSTOMER][NEUTRAL] From the mailing address?
[AGENT][NEUTRAL] And our mailing
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] Thank you for the confirmation.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yeah, I got the information. Thank you for assisting. Can I get the call reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you. Yeah, thank you for the information. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're very welcome.
[AGENT][POSITIVE] You also, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.