AccountId: 011433970860
ContactId: a067c50e-c3e7-4652-9db3-0023d8bfc26c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 589760 ms
Total Talk Time (AGENT): 135341 ms
Total Talk Time (CUSTOMER): 156400 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/a067c50e-c3e7-4652-9db3-0023d8bfc26c_20250314T21:17_UTC.wav
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[AGENT][NEUTRAL] Calling
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office, checking on the claim.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] All right, [PII], I'm happy to check a claim for you today. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Sure. And it is 17672.
[AGENT][NEUTRAL] 17672.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] It's not coming up as a valid policy number. Do you have the member's name or social?
[CUSTOMER][NEUTRAL] Mm, I do have a member's name, the last name, uh, let, let me know when you're ready.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, the last name is spelled as [PII] Echo Yankee Echo [PII].
[CUSTOMER][NEUTRAL] And the first name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, one moment, let me take a look.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if I can have patient's date of birth?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] What state do they live in?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What state do they live in? Do you know?
[CUSTOMER][NEUTRAL] It's [PII], yeah.
[AGENT][NEUTRAL] And date of birth was [PII], correct?
[CUSTOMER][POSITIVE] Yeah, that's perfect.
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] Do you have a claim number or anything? Because I'm not finding a policy that matches that info.
[CUSTOMER][NEUTRAL] Mhm. Actually, the patient is a newborn.
[CUSTOMER][NEUTRAL] Can you check with the member's uh name and date of birth?
[AGENT][NEUTRAL] What is the member's name?
[CUSTOMER][NEUTRAL] The member's last name is spelled as [PII], and the first name is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the date of birth will be
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, let me try that way one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] All right, so I was able to find a policy for [PII], however, this is only for the insured. There's no dependents listed on here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Can you check whether the dependent is covered for the 1st 30 days of bond?
[AGENT][NEUTRAL] Let me double check one moment.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Last.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. So it looks like newborn children are covered automatically on the day they were born as long as the coverage is active and the policy was effective. The effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, they're just required to notify us of the birth of the child within 30 days.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, can you check if there any claim on the subscriber name?
[AGENT][NEUTRAL] For what data service?
[CUSTOMER][NEUTRAL] It's on [PII].
[AGENT][NEUTRAL] And what was the bill amount?
[CUSTOMER][NEUTRAL] And now
[CUSTOMER][NEUTRAL] OK. It's $911 911 dollars even.
[AGENT][NEUTRAL] Do you have an amount after the primary?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] I, I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, see that I have.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, so I only have one claim on file for that date of service, but it's not for that bill amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. Can I check with $250? Is that right?
[AGENT][NEUTRAL] I have one for $236.36.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's the only claim on file.
[CUSTOMER][NEUTRAL] Actually, we have billed it as, yeah, we have billed it as secondary insurance but it is showing like that.
[CUSTOMER][NEUTRAL] Can I have the claim number of that one?
[AGENT][NEUTRAL] That's why I was
[AGENT][NEUTRAL] Yeah, the claim number is 356-832-8.
[CUSTOMER][NEUTRAL] I'm, I'm sorry, I didn't catch that.
[AGENT][NEUTRAL] 356.
[AGENT][NEUTRAL] 83
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 28
[CUSTOMER][NEUTRAL] And what was the status of it?
[AGENT][NEUTRAL] There was a benefit payment sent in the amount of 236.36 to the provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And under, under the EFT number?
[AGENT][NEUTRAL] It was a single check, the check number is 202.
[AGENT][NEUTRAL] 971 8.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And can you check with uh another date of service? It's [PII].
[AGENT][NEUTRAL] No claims on file for that date of service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And can I have the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial in today's date. My name again is [PII], that's [PII]
[AGENT][NEUTRAL] My last initial is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] And thank you, sir, thank you for assisting me today and have a great weekend.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Bye bye.