AccountId: 011433970860
ContactId: a036be16-a9f8-451e-93a9-f5d3c918b05f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 474600 ms
Total Talk Time (AGENT): 128596 ms
Total Talk Time (CUSTOMER): 133311 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/a036be16-a9f8-451e-93a9-f5d3c918b05f_20250203T22:02_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] calling to check on a claim.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim, [PII]. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure. The policy ID is 02448967ML7.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm. Sure.
[AGENT][NEUTRAL] And can you, can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII], [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 and the total bills?
[CUSTOMER][NEUTRAL] [PII] and the charge amount will be $47,116.86.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] So I'm not sure. I do, there's a few claims that came in on [PII] with the date of service [PII], but there's no date range. Would this be like a facility charge?
[CUSTOMER][NEUTRAL] Uh, it's in uh UB04 claim.
[CUSTOMER][NEUTRAL] And one moment. Uh, could you please check, do you have a claim for $46,699.56?
[AGENT][NEUTRAL] I don't see anything for that close to that total at all. Um, hold on one second, let me go through the claims for this day.
[AGENT][NEUTRAL] Um, hold on one moment, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] do.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. So for your date of service, we have not received um a claim with your total bill.
[AGENT][NEUTRAL] Or close to the total bill, and it
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, uh, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you please check whether the uh member is active for the date of service?
[AGENT][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, yes, the policy has been active since [PII].
[CUSTOMER][NEUTRAL] And it's still active, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Uh, just allow me one quick moment, and I could see, uh, previously we filed the claim through the paper and could you please help me with your mailing address?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][POSITIVE] Perfect. Thank you. Thank you so much. And for my documentation, could you also please help me with your fax number and the payer ID?
[AGENT][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Attention APL claims department.
[AGENT][NEUTRAL] And our payer ID?
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And could you please help me with the member plan type?
[AGENT][NEUTRAL] Sure, this is the Medin supplemental gap insurance.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you also please help me with the group number and the group name, please?
[AGENT][NEUTRAL] Yes, the group number is 23839.
[AGENT][NEUTRAL] For Pure Source LLC.
[CUSTOMER][POSITIVE] Perfect. Thank you. And
[CUSTOMER][NEUTRAL] For reference, can I use your name in today's date?
[AGENT][NEUTRAL] Yes, that's correct. And the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All right, thank you. And, and may I know how many claims can you assist you with the call?
[AGENT][NEUTRAL] Um, how many claims do you have today?
[CUSTOMER][NEUTRAL] Uh, one moment, I'll check make a look of that.
[CUSTOMER][NEUTRAL] I do have 4 more.
[AGENT][NEUTRAL] OK, so you have 5 in total.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the next member's policy number?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The next ID number will be 02451594 M like Mike Lima number 7.
[AGENT][NEUTRAL] OK. Do you mind if I place you on a brief hold?
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] One X for total.
[AGENT][NEUTRAL] And you knew that.
[AGENT][NEUTRAL] Oh.