AccountId: 011433970860
ContactId: afe35110-4162-4cb4-999b-9dd4770cc645
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 281100 ms
Total Talk Time (AGENT): 109887 ms
Total Talk Time (CUSTOMER): 114002 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/afe35110-4162-4cb4-999b-9dd4770cc645_20250404T17:44_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is how may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], um, good afternoon. My name is [PII] and I'm calling on behalf of Miami Psychiatric Services, and I'm calling in reference to, um, one of our patients. She has a gap insurance with you, and we have done claims, um, for her, and I would like to know what is the status.
[AGENT][NEUTRAL] Can I have a callback number for you and that policy number and my name is [PII]
[CUSTOMER][NEUTRAL] Oh [PII].
[CUSTOMER][NEUTRAL] Uh, [PII] callback number is [PII]. My name is [PII], first initial [PII]
[AGENT][NEUTRAL] Thank you, and the policy number of the member that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Yeah, policy is 202141814.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it's [PII], and date of birth is [PII].
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Uh let me see, give me one second.
[CUSTOMER][NEUTRAL] I'm talking about um date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII] and [PII].
[AGENT][NEUTRAL] So I can only look at one claim at a time. So what is the first date of service in the year? Is it [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] That would, that would be in 90792.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] This claim was received [PII]. It was processed [PII]. There was no payment made on this claim, mainly because the policy is request we're requesting.
[AGENT][NEUTRAL] Hold on, that's not it.
[AGENT][NEUTRAL] We're requesting the EOB.
[CUSTOMER][NEUTRAL] And EOB from the primary insurance?
[AGENT][NEUTRAL] This is a gap insurance, yes.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK, let me, well then that that's OK because if that's the first one and you're you wanna um.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The you'll be probably you want the you'll be for the rest of them. OK, let me, let me, um.
[AGENT][NEUTRAL] Yes, ma'am. So let me give you the claim number.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] The claim number is 3555868.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's 355-586.
[CUSTOMER][NEUTRAL] And what would that EOB be sent to?
[AGENT][NEUTRAL] It, it'll be sent the EOB will be sent over to [PII].
[CUSTOMER][NEUTRAL] 8.
[AGENT][NEUTRAL] 248,950 that's [PII], or you can send it to us by fax as well. Would you like that fax number?
[CUSTOMER][NEUTRAL] What is the fax? Mhm.
[AGENT][NEUTRAL] It is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much, [PII] appreciate it.
[AGENT][NEUTRAL] And we have a payer ID as well, would, would you like the payer ID?
[CUSTOMER][NEUTRAL] Payer ID?
[AGENT][NEUTRAL] I mean, the yes, the electronic payer ID to send it electronically.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is 60801 60801.
[CUSTOMER][NEUTRAL] Uh-huh, what is the?
[CUSTOMER][NEUTRAL] 608.
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[CUSTOMER][NEUTRAL] No, that's OK. I'm, I'm not gonna uh go over the other ones because probably it's gonna be the same reason.
[AGENT][POSITIVE] All right, well, thanks for calling APL and you have a great day.
[CUSTOMER][POSITIVE] All right, thank you. Thank you, you too, bye.
[AGENT][POSITIVE] You're welcome. Goodbye.