AccountId: 011433970860
ContactId: a3b44e57-3d79-4c68-bd5f-93cd4caf5c1e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 642450 ms
Total Talk Time (AGENT): 191611 ms
Total Talk Time (CUSTOMER): 225106 ms
Interruptions: 5
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/a3b44e57-3d79-4c68-bd5f-93cd4caf5c1e_20250402T17:44_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.
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Relis Emergency Medicine Specialist checking for claim.
[AGENT][POSITIVE] OK, well I'll be more than happy to help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Contact number [PII].
[AGENT][NEUTRAL] Thank you. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have 3 clients today.
[AGENT][NEUTRAL] And may I have the first member's policy number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Policy number is D like Delta 40407107.
[AGENT][NEUTRAL] And do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] No, I don't have.
[AGENT][NEUTRAL] OK, um, do you have the member's full social?
[CUSTOMER][NEUTRAL] Uh, full social, one moment.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, I have social [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Hold on
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I'm just waiting for the policies to populate here.
[AGENT][NEUTRAL] And what is the member's first and last name?
[CUSTOMER][NEUTRAL] Yes, my name.
[CUSTOMER][NEUTRAL] [PII], date of birth of [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And all the information provided is a verification of benefits, not a guarantee of payment. And is this for a medical claim?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII]. The charge amount of $644 even $644.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm let me see if this is it and what is the name of the provider on the um claim?
[CUSTOMER][NEUTRAL] Let me see this is it.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Group name is Emergency medicine specialist, rendering provider name [PII].
[AGENT][NEUTRAL] What's the tax ID?
[CUSTOMER][NEUTRAL] What's the tax ID ID number is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so we only, um, we've only received one claim for that data service, but it is a different provider and a different um bill amount. So we don't have your claim on file. Let me see if there was another.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Policy. No, that's the only one.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we don't have a claim on file for your policy also or your claim and also there were no policies active on your data service. Uh, this policy terminated on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] it's.
[CUSTOMER][NEUTRAL] Oh, no longer act the termination of [PII], correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, thank you so much for that. Could you please move with the next patient?
[AGENT][NEUTRAL] Um, hold on one moment, let me note this policy.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Um
[AGENT][POSITIVE] Very fine.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait and the next member's um policy number?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I have policy number 404-088888.
[AGENT][NEUTRAL] 404-088-888.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, that's not an APL policy number. Do you have the ID card available?
[CUSTOMER][NEUTRAL] No, this one also I don't have ID card.
[AGENT][NEUTRAL] OK, um, do you have their social?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] One moment, I'll try to find the source here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have the social [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And may I have the member's first and last name?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, hold on one moment. Um, can you spell the last name for me, please?
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. I'm gonna look with the name. There was no policy that populated with the social.
[CUSTOMER][NEUTRAL] With the
[AGENT][NEUTRAL] I'm gonna search with the first and last name for you.
[CUSTOMER][NEUTRAL] I'm gonna start with the first and last name first.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And is [PII] the policyholder?
[CUSTOMER][NEUTRAL] Um, one moment.
[AGENT][NEUTRAL] Oh, would it be under another name?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Yes, [PII] is the help.
[AGENT][NEUTRAL] OK. Well, if that's the case, then I'm not showing a policy here, um, using the social or the first and last name.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] I'm not sure I'm I'm using the social or the.
[CUSTOMER][NEUTRAL] Oh, OK. Could you please move the last patient?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have social for that one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] And I'm ready when you are.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the member's first and last name?
[CUSTOMER][NEUTRAL] Yes, number's name.
[CUSTOMER][NEUTRAL] [PII] of [PII].
[AGENT][NEUTRAL] Hold on one moment, I believe I just located a policy.
[CUSTOMER][NEUTRAL] I believe I just.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you um verify the date of birth again? I wasn't in the policy at the time.
[CUSTOMER][NEUTRAL] And can I
[CUSTOMER][NEUTRAL] Yes. Yes. [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. And uh may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] The charge amount of $1,118 even 1118.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And wait a minute, you said that this was medical, they only, he only has a dental policy with APL.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] dental policy.
[CUSTOMER][NEUTRAL] Can I have the member ID number?
[AGENT][NEUTRAL] Yes, for the dental policy, it's 243.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] 72
[AGENT][NEUTRAL] 27
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK. This number only dental policy, no medical coverage.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can I get the
[CUSTOMER][NEUTRAL] Oh my.
[CUSTOMER][NEUTRAL] Can I get the reference number for our conversation now?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and that's [PII].
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][POSITIVE] OK, thank you so much for that. I wish you have a wonderful day. Thank you.
[AGENT][POSITIVE] Thank you, [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] No, that's all for it. Thank you so much.
[AGENT][POSITIVE] Alright thanks thanks for calling APL bye bye.
[CUSTOMER][POSITIVE] Thanks for calling APL.