AccountId: 011433970860
ContactId: 9dc8de74-c020-4a01-9876-b3c730fb0c4f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 440579 ms
Total Talk Time (AGENT): 185318 ms
Total Talk Time (CUSTOMER): 145133 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/9dc8de74-c020-4a01-9876-b3c730fb0c4f_20250408T15:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, I'm [PII] calling from Pros office. I want to know the claim status.
[AGENT][NEUTRAL] What was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Spell your name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status.
[CUSTOMER][NEUTRAL] And the first initial of
[AGENT][NEUTRAL] Uh yes, go ahead. Your first initial and last name?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you, and your callback number please, [PII]?
[CUSTOMER][NEUTRAL] Uh, callback number is
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And how many claims rocks do you have to check status on today?
[CUSTOMER][NEUTRAL] Uh 2 claims for the same patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, 2 claims for the same patient.
[CUSTOMER][NEUTRAL] Oh, sorry, sorry, sorry. It's different patient.
[AGENT][NEUTRAL] So you have one day of service for
[CUSTOMER][NEUTRAL] Uh, no, it's different patient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's different date of service. I just want to, OK. So, can you please assist me with that?
[AGENT][NEUTRAL] You have 2 patients and they each have 1 data service. Is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes. 2 patients, different date of service, different billing amount.
[AGENT][POSITIVE] Yes, I can help you with that.
[AGENT][POSITIVE] Yes, I can help you. And [PII] will use my name. No, just a moment.
[CUSTOMER][NEUTRAL] OK, fine.
[CUSTOMER][NEUTRAL] So can I start with?
[AGENT][NEUTRAL] So you will use my name that I gave you along with today's date as your call reference number for each one. Also any information that I provide for you today will be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK, fine.
[AGENT][NEUTRAL] And lastly [PII], if we do have the claims on file and you need a copy of the explanation of benefits, you may print those once you have the claim numbers by going to our portal which is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the first patient's policy number, please?
[CUSTOMER][NEUTRAL] OK, fine.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Patient policy number is
[CUSTOMER][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 171624635
[AGENT][NEUTRAL] OK, I'm sorry. Say that number again because that's gonna be too many numbers for APL.
[CUSTOMER][NEUTRAL] OK. 171624.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 635.
[AGENT][NEUTRAL] OK, so that is, that's not an American public life policy number. That is too many numbers.
[AGENT][NEUTRAL] Do you have a copy of the ID card?
[CUSTOMER][NEUTRAL] OK. So can
[CUSTOMER][NEUTRAL] Uh, no, I don't have a copy of ID card. Uh, I have SSN of the patient.
[AGENT][NEUTRAL] Is the patient the policy holder?
[AGENT][NEUTRAL] Is your patient the primary subscriber? OK, what is the social?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. It is [PII].
[AGENT][NEUTRAL] OK, that's the number that you gave me as the policy number. That's their social security number?
[CUSTOMER][NEUTRAL] OK, fine.
[AGENT][NEUTRAL] And there's no one in our system with that social security number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, claim is not on file, right?
[AGENT][NEUTRAL] No member in our system by that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Claim is not on file, right?
[AGENT][NEUTRAL] No member with a policy with that social security number.
[AGENT][NEUTRAL] There's no one in our system that has a social security number that matches what you gave me.
[AGENT][NEGATIVE] No member found.
[AGENT][NEUTRAL] Not just the claim, but no member.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, fine.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So we need to rebuild the claim.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEGATIVE] The information you gave me does not show.
[AGENT][NEUTRAL] That we have a member.
[AGENT][NEUTRAL] With information matching that social.
[AGENT][NEGATIVE] We don't even show that someone with that Social Security number has coverage with our company.
[CUSTOMER][NEUTRAL] OK, fine. Then.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, fine. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] So, let's talk about next.
[CUSTOMER][NEUTRAL] Clinics to
[CUSTOMER][NEUTRAL] Next claim
[CUSTOMER][NEUTRAL] I'm just providing you the next patient ID.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Nexts.
[AGENT][NEUTRAL] So this is also a social security number? OK.
[CUSTOMER][NEUTRAL] Just check it once.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][POSITIVE] Yes, yes, yes, yes.
[CUSTOMER][NEUTRAL] OK, the next social security number is [PII].
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there is no one in our system with that social security number.
[AGENT][NEGATIVE] No member found.
[CUSTOMER][NEUTRAL] OK, fine.
[CUSTOMER][NEUTRAL] November found. OK, fine.
[AGENT][POSITIVE] OK. Good. OK, [PII]. So is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, for reference. Can you please, can you please, can you please tell your name once?
[AGENT][NEUTRAL] Yes, sir. I, I gave you.
[CUSTOMER][NEUTRAL] Can you spell your name?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] OK, fine. Thank you.
[AGENT][POSITIVE] Well, you're welcome, [PII] and Again, is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No. Thank you so much.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you for calling APL.