AccountId: 011433970860
ContactId: 9f8b7d4c-15da-49f2-bb63-93a2318ecc47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249300 ms
Total Talk Time (AGENT): 110410 ms
Total Talk Time (CUSTOMER): 97260 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/9f8b7d4c-15da-49f2-bb63-93a2318ecc47_20250325T19:15_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] Yes, Ms. [PII], my name is [PII] I'm calling from Stoughton Memorial Hospital, and I need to get some claim from a claim please.
[AGENT][NEGATIVE] OK, the phone's breaking up. You said you need some claims and then I didn't hear anything else.
[CUSTOMER][NEUTRAL] Yes ma'am, and my name is [PII]
[AGENT][POSITIVE] Oh, yes, so I'll be more than happy to help you with the claims, and are you a provider or you're the insured?
[CUSTOMER][NEUTRAL] I'm a provider.
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, my direct line is [PII].
[AGENT][NEUTRAL] All right. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It's 257-1322.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Her birthday 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 you like me to check on?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII] and the charge is $485.
[AGENT][NEUTRAL] Thank you. And again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. Um, let me double check this.
[AGENT][NEUTRAL] Well, OK, so I'm actually showing we've never processed a claim for [PII]. Um, there's like no claims on file, but there is no timely filing and the policy didn't lapse until [PII], so it was active on your data service. If you did want to file the claim, you still can.
[CUSTOMER][NEUTRAL] OK, and you said the term date is [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, now let me make sure we have the address right because this is one of them strange policies we have uh [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII], OK, see, that's why y'all didn't get it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me double check though because they do have hospital indemnity. So sometimes, sometimes it comes to us, sometimes it goes to them. So let me double check, you, you may be right, but on this screen it looks like it's, hold on one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh no, you're right. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, yes, ma'am, you got it. This one does go there.
[CUSTOMER][NEUTRAL] So that is
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And we have the group ID as 70044.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I don't know why it did um.
[CUSTOMER][NEUTRAL] Why I didn't reach you because it's, it's been out there a while and I was like, oh, OK, Ms. [PII], can I please have a um [PII] to your last name and the, a reference number, please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name. Um, the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And, and for the claim, we also have a um payer ID. Did you need that or the fax number is good or the mailing address is good?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] The mailing address I'll send it electronically.
[AGENT][NEUTRAL] Hm OK. Well, was, was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] No, ma'am, that's it. I appreciate your help. You have a great rest of your day.
[AGENT][POSITIVE] You're very welcome. You also and thanks for calling APL.
[CUSTOMER][NEUTRAL] OK, bye bye, bye bye.
[AGENT][NEUTRAL] Bye bye.