AccountId: 011433970860
ContactId: b101af01-2c0f-4a18-a0fe-23d5df142346
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 505089 ms
Total Talk Time (AGENT): 108685 ms
Total Talk Time (CUSTOMER): 142121 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/b101af01-2c0f-4a18-a0fe-23d5df142346_20250204T15:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I'm calling for the provider Jenny Stewart Medical Center Inc. Please note this call is being recorded and monitored for quality and training purpose, and I'm calling to check on a claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can you please give me um your name again, sir, and your call back number?
[CUSTOMER][NEUTRAL] Um, yes, my name is [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And the callback number is [PII].
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] So the patient's first name is spelled as [PII].
[AGENT][NEUTRAL] OK, what is the
[CUSTOMER][NEUTRAL] And the last name is.
[AGENT][NEUTRAL] Date of birth. Uh-huh. Go ahead.
[CUSTOMER][NEUTRAL] Yeah, so the last name is uh A.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Then what's the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and policy number?
[CUSTOMER][NEUTRAL] Um, actually I have a policy number, uh, it's uh starting with the letter D as in Delta. So that's D as in Delta 42030118.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, and then you spell the first name [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh let me see if I can find it by the name.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and what um type of claim is this? Is it medical?
[CUSTOMER][NEUTRAL] Medical
[AGENT][NEUTRAL] What kind is it? Medical?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the data of service?
[CUSTOMER][NEUTRAL] So the rate of service is on [PII] and the charge amount is $331.24.
[AGENT][NEUTRAL] OK, you said the name of the facility was JD Stewart, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm gonna on a brief hold. [PII], while I try to find this for you and I'll.
[CUSTOMER][NEUTRAL] Sure, mhm, alright.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hi [PII], this is with again. So looking for the data service of [PII]. I do not send a client on file for the insured.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So there is no claim on file?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, I'm sorry, actually your voice is cutting in and out. I'm sorry, sir.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello? No, there is not a claim on file.
[CUSTOMER][NEUTRAL] So, I mean, yes.
[CUSTOMER][NEUTRAL] May I have the patient span effective date and the termination date?
[AGENT][NEUTRAL] Yes, the effective date is [PII].
[AGENT][NEUTRAL] Termination date is [PII].
[CUSTOMER][NEUTRAL] And this is the primary insurance for this member?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh, so this is not the primary, is this a secondary?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] It's a limited hospital indemnity plan.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So, no, actually, I just wanted to know whether uh we need to submit the claim to you as a primary or as a secondary.
[AGENT][NEUTRAL] You can submit the plan.
[AGENT][NEUTRAL] As a primary,
[AGENT][NEUTRAL] We're not, we're not a major medical.
[CUSTOMER][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] Mm, OK, I understand. Thank you. And may I have the claim mailing address?
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] And the pay ID?
[AGENT][NEUTRAL] The payer ID is 60801.
[CUSTOMER][NEUTRAL] And may I have the time refunding limit to submit the claim?
[AGENT][NEUTRAL] We don't have one.
[CUSTOMER][NEUTRAL] OK. And uh actually we submitted the claim to the address [PII]. So that's the incorrect mailing address, right?
[AGENT][NEUTRAL] Right, um, now I can transfer you over to IMA. You could check to see if they have the claim on file.
[CUSTOMER][NEUTRAL] Um, no, I I try with them. They said that all they only transfer the call to you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh may I know the preferred way to submit the claim?
[CUSTOMER][NEUTRAL] Either is it through electronic or by mail?
[AGENT][NEUTRAL] Up to, up to you.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, could you repeat it one more time?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Um, hello, I'm I audible?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, am I audible?