AccountId: 011433970860
ContactId: 98f0cf8c-17df-4205-87e6-eb3806ed3983
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 963000 ms
Total Talk Time (AGENT): 204285 ms
Total Talk Time (CUSTOMER): 212760 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/98f0cf8c-17df-4205-87e6-eb3806ed3983_20250127T20:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, yes, hi [PII]. My first name is [PII], my last name is [PII] calling you from the provider's office looking for claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility or place where you're calling from?
[CUSTOMER][NEUTRAL] Saint Mary Hospital.
[AGENT][NEUTRAL] OK, and I call back um and the phone number I'm sorry, the account number, the insurance policy number.
[CUSTOMER][NEUTRAL] 02450110.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, the patient's date of birth is [PII], and the first name is [PII] and the last name is [PII]
[AGENT][NEUTRAL] Alright. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] total charge is $14,788.89.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, let me see if I can find this claim, and that was [PII]. And for future, you can check claim status online through our website at [PII], and that's just optional.
[AGENT][NEUTRAL] Bear with me.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] I have no claims on file for [PII].
[CUSTOMER][NEUTRAL] OK, can I have the member effective date?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, the effective date on this policy for June, we have [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] And there is no timely filing limit, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you, let's move to the next patient.
[AGENT][NEUTRAL] OK, if you have a next patient, bear with me just a minute. Let me finalize the note on this one, OK.
[AGENT][NEUTRAL] It'll be one more minute.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] And the next city is.
[CUSTOMER][NEUTRAL] 01991154.
[AGENT][NEUTRAL] Mm, that's too many numbers to be one of our policy numbers, Mr. [PII]. Our numbers are small, like the first one you gave me.
[CUSTOMER][NEUTRAL] So, uh, just to reconfirm again, the ID is 01991154.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Date of birth is uh [PII]. 1st name is [PII] and the last name is [PII].
[AGENT][NEUTRAL] OK, what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] total charge is $1,648.50.
[AGENT][NEUTRAL] That was [PII], correct?
[CUSTOMER][NEUTRAL] Yes, in [PII].
[AGENT][NEGATIVE] Claim is not on file.
[CUSTOMER][NEUTRAL] OK, can I have the member's effective date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, the effective date is [PII] and it terminated on [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][POSITIVE] Thank you, let's move to the next version.
[AGENT][NEUTRAL] One moment, let me make a note.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And this is also from Saint Mary's Hospital for this member?
[CUSTOMER][NEUTRAL] Uh, yes, but, uh, it is under different NDI.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it's OK. I just need the name of the facility or the provider that you're calling from.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and what is the next one?
[CUSTOMER][NEUTRAL] Uh, the next set is 0163191.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII]. 1st name is [PII], last name is [PII].
[AGENT][NEUTRAL] Thank you. And what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, date of services [PII] total charge is $3,182.49.
[AGENT][POSITIVE] OK, thank you
[AGENT][NEGATIVE] Clay is not on file.
[CUSTOMER][NEUTRAL] Uh, the member's effective date.
[AGENT][NEUTRAL] Effective date is [PII] and it is active at the moment.
[CUSTOMER][NEUTRAL] Thank you. Let's move to the next question. I still have just, uh, 2 more 2 more claims.
[AGENT][NEUTRAL] OK, bear with me, I just need to make a note.
[AGENT][NEUTRAL] And this was also for St. Mary's Hospital, correct?
[CUSTOMER][NEUTRAL] Uh, Saint Francis Hospital.
[AGENT][NEUTRAL] Francis, OK.
[AGENT][NEUTRAL] OK, that's the next one.
[CUSTOMER][NEUTRAL] Next ID is 02456419.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and the first name is [PII], last name is [PII].
[AGENT][NEUTRAL] OK, you said the date of birth was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, the data service [PII] total charge is $730 even.
[AGENT][NEUTRAL] And that's [PII] 24.
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, we have not received that claim.
[CUSTOMER][NEUTRAL] Uh, members effectively.
[AGENT][NEUTRAL] OK, we have an effective date of [PII] and it is active at the moment and this is one of our secondary supplemental plans for the major medical.
[CUSTOMER][NEUTRAL] OK, thank you. Let's move to the last patient.
[AGENT][NEUTRAL] Bear with me, let me make a note.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] OK, the member's ID is 01739550.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have the name and date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII]. 1st name is [PII], last name is [PII].
[AGENT][NEUTRAL] OK, and what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, [PII]. Total charge is $860 even.
[AGENT][NEUTRAL] No it's of [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, bear with me.
[AGENT][NEUTRAL] I don't see the facility charges. Now, this policy has been terminated since [PII]. Let me give you the effective date.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This one was effective [PII] and it terminated [PII].
[CUSTOMER][NEGATIVE] So it is no more active on the date of service.
[AGENT][NEUTRAL] It's not active on the date of service and there's no other policies available for this number.
[CUSTOMER][NEUTRAL] OK, and also um.
[CUSTOMER][NEUTRAL] There is no claim on file as well, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And do you have any call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK, OK, thank you so much. That's all I need for today and have a very blessed day.
[AGENT][POSITIVE] You as well. Thank you for calling APL. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] Yeah