AccountId: 011433970860
ContactId: a6a8f566-d18e-4a9a-a484-5bb1d0c25f7f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427519 ms
Total Talk Time (AGENT): 192704 ms
Total Talk Time (CUSTOMER): 125094 ms
Interruptions: 6
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/a6a8f566-d18e-4a9a-a484-5bb1d0c25f7f_20250328T12:43_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] right
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from provider office for status.
[AGENT][NEUTRAL] I'm so sorry. I can barely hear you.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I'm calling from provider office.
[AGENT][POSITIVE] OK, that's much better. So you're calling from our provider's office and how can I help you today?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Uh, sure, I needed a general claim status.
[AGENT][NEUTRAL] You're needing claim status?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, I can help you with that. And did you say that your name was [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, thank you and [PII], what is your call back number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], let's say that again. [PII].
[CUSTOMER][NEUTRAL] Just a moment. [PII].
[AGENT][NEUTRAL] [PII]. OK, [PII], can we say that like a phone number, please? [PII].
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And how many claims, [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] One.
[AGENT][NEUTRAL] Yes, I can help you with that. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Um, the policy number I have is 022-03915.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up.
[AGENT][NEUTRAL] And any information, [PII], that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mm just a moment. Yeah. The last name is [PII] First name is [PII] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him, please?
[CUSTOMER][NEUTRAL] Um, the service I have is February [PII], 2024 and the charge amount is $353.
[AGENT][NEUTRAL] And you said data services 325 of 2024 for $353 is that correct?
[CUSTOMER][NEUTRAL] No, ma'am, that service is 02232024.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] 023 OK and the amount is 353, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, so I do not have a claim on file for him, for [PII], for this data service and this billed amount.
[CUSTOMER][NEUTRAL] Could you please check one more time the data service is 02-232024.
[AGENT][NEUTRAL] That is correct. And there is no claim on file?
[CUSTOMER][NEUTRAL] It's Feb February [PII].
[AGENT][NEUTRAL] That is correct. And for the billed amount of $353 there is no claim on file.
[CUSTOMER][POSITIVE] I do right away.
[CUSTOMER][NEUTRAL] OK. Uh, could you please confirm me the, uh, eligibility date for this number?
[AGENT][NEUTRAL] I can. That would be [PII].
[CUSTOMER][NEUTRAL] And the term date?
[AGENT][NEUTRAL] No term date?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] No term date. The policy is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then [PII], because this is a supplemental policy to their primary insurance, when the claim is submitted to APL for review, we must also have a copy of his primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then once we have processed our claim we do have a portal that you can check claim status for us by going to [PII].
[CUSTOMER][NEUTRAL] and
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just.
[CUSTOMER][NEUTRAL] OK. Please confirm me the mailing address to submit your claim.
[AGENT][NEUTRAL] Plain's mailing address is [PII].
[AGENT][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] And do you have a fax number or something else?
[AGENT][NEUTRAL] Fax number is [PII] attention claims.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And what's the timely filing for some insurance plan?
[AGENT][NEGATIVE] There is no timely filing limit with APL.
[CUSTOMER][NEUTRAL] Mhm. OK, and what's the reference number?
[AGENT][NEUTRAL] My name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Could you please spell out your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, sorry, I'm not able to hear you. What?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And is there anything else, [PII], I can help you with?
[CUSTOMER][NEUTRAL] Last name, [PII].
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] S and yours?
[AGENT][NEUTRAL] What is your last name initial? You did not give me that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] What's your notable here.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is my voice not audible to you, [PII]?
[CUSTOMER][POSITIVE] OK, thank you for confirming it.
[CUSTOMER][POSITIVE] Have a nice day. Goodbye.
[AGENT][NEUTRAL] OK, well that that's all I